| NPI | 1184624520 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152WV0400X Optometrist, Vision Therapy (Licence: CO 2393) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CO 2393) |
| Enumeration Date | 2005-07-28 |
| Last Update Date | 2019-12-26 |