| NPI | 1003220138 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: SC 1823) |
| Additional Taxonomies | 152WC0802X Optometrist Corneal and Contact Management (Licence: SC 1823) |
| 152WL0500X Optometrist Low Vision Rehabilitation (Licence: SC 1823) | |
| 152WP0200X Optometrist Pediatrics (Licence: SC 1823) | |
| 152WV0400X Optometrist Vision Therapy (Licence: SC 1823) | |
| Enumeration Date | 2014-06-17 |
| Last Update Date | 2017-01-26 |