NPI | 1194774224 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 152W00000X Optometrist (Licence: OR 2094T) |
Additional Taxonomies | 152WC0802X Optometrist Corneal and Contact Management (Licence: OR 2094T) |
152WP0200X Optometrist Pediatrics (Licence: OR 2094T) | |
152WS0006X Optometrist Sports Vision (Licence: OR 2094T) | |
152WV0400X Optometrist Vision Therapy (Licence: OR 2094T) | |
152WX0102X Optometrist Occupational Vision (Licence: OR 2094T) | |
332H00000X Eyewear Supplier (Licence: OR 2094T) | |
Enumeration Date | 2006-05-08 |
Last Update Date | 2012-09-26 |