| NPI | 1003545658 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CT 3266) |
| Additional Taxonomies | 152WP0200X Optometrist, Pediatrics (Licence: CT 3266) |
| 152WV0400X Optometrist, Vision Therapy (Licence: CT 3266) | |
| Enumeration Date | 2022-06-08 |
| Last Update Date | 2024-02-14 |