| NPI | 1992108484 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: GA OPT002854) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: AL S-D20-TA-A12) |
| Enumeration Date | 2014-09-29 |
| Last Update Date | 2015-10-29 |