| NPI | 1326122680 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OR 2635 ATI) |
| Additional Taxonomies | 152WV0400X Optometrist, Vision Therapy (Licence: OR 2635ATI) |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2008-04-30 |