| NPI | 1053380162 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: PR 106) |
| Additional Taxonomies | 152WV0400X Optometrist Vision Therapy (Licence: PR 106) |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2008-12-16 |