| NPI | 1003812256 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AZ 520) |
| Additional Taxonomies | 152WC0802X Optometrist, Corneal and Contact Management (Licence: AZ 520) |
| 152WP0200X Optometrist, Pediatrics (Licence: AZ 520) | |
| 152WV0400X Optometrist, Vision Therapy (Licence: AZ 520) | |
| Enumeration Date | 2005-06-22 |
| Last Update Date | 2008-02-27 |