| NPI | 1073557112 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: KS 1338) |
| Additional Taxonomies | 152WP0200X Optometrist Pediatrics (Licence: KS 1338) |
| 152W00000X Optometrist (Licence: MO T03004) | |
| 152WP0200X Optometrist Pediatrics (Licence: MO T03004) | |
| 152WV0400X Optometrist Vision Therapy (Licence: KS 1338) | |
| 152WV0400X Optometrist Vision Therapy (Licence: MO T03004) | |
| 152WX0102X Optometrist Occupational Vision (Licence: KS 1338) | |
| 152WX0102X Optometrist Occupational Vision (Licence: MO T03004) | |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2021-09-23 |