| NPI | 1306075882 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CT 002779) |
| Additional Taxonomies | 152WV0400X Optometrist Vision Therapy (Licence: CT 002779) |
| Enumeration Date | 2009-07-06 |
| Last Update Date | 2013-10-28 |