| NPI | 1154300309 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152WP0200X Optometrist, Pediatrics (Licence: MD TPA0849) |
| Additional Taxonomies | 152WV0400X Optometrist, Vision Therapy (Licence: MD TA849) |
| Enumeration Date | 2006-01-14 |
| Last Update Date | 2010-08-05 |