| NPI | 1316931694 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OK OK2400) |
| Additional Taxonomies | 152WV0400X Optometrist, Vision Therapy (Licence: OK OK) |
| Enumeration Date | 2005-09-01 |
| Last Update Date | 2023-03-01 |