NPI | 1184611568 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: AZ 969) |
Additional Taxonomies | 152WV0400X Optometrist, Vision Therapy (Licence: AZ 969) |
152WP0200X Optometrist, Pediatrics (Licence: AZ 969) | |
152WS0006X Optometrist, Sports Vision (Licence: AZ 969) | |
Enumeration Date | 2005-09-30 |
Last Update Date | 2017-04-04 |