| NPI | 1053359463 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MI 4901003586) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OH 4166T602) |
| 152WC0802X Optometrist Corneal and Contact Management (Licence: OH 4166T602) | |
| 152WC0802X Optometrist Corneal and Contact Management (Licence: MI 4901003586) | |
| 152WL0500X Optometrist Low Vision Rehabilitation (Licence: OH 4166T602) | |
| 152WL0500X Optometrist Low Vision Rehabilitation (Licence: MI 4901003586) | |
| 152WP0200X Optometrist Pediatrics (Licence: OH 4166T602) | |
| 152WP0200X Optometrist Pediatrics (Licence: MI 4901003586) | |
| 152WS0006X Optometrist Sports Vision (Licence: OH 4166T602) | |
| 152WS0006X Optometrist Sports Vision (Licence: MI 4901003586) | |
| 152WV0400X Optometrist Vision Therapy (Licence: OH 4166T602) | |
| 152WV0400X Optometrist Vision Therapy (Licence: MI 4901003586) | |
| 152WX0102X Optometrist Occupational Vision (Licence: OH 4166T602) | |
| 152WX0102X Optometrist Occupational Vision (Licence: MI 4901003586) | |
| Enumeration Date | 2006-06-04 |
| Last Update Date | 2007-07-08 |