| 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 |