| NPI | 1982838975 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: GA Opt 002651) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TX 7349T) |
| Enumeration Date | 2009-05-06 |
| Last Update Date | 2018-02-16 |