| NPI | 1326265562 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152WV0400X Optometrist Vision Therapy (Licence: CT 2299) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CT 2299) |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2012-03-13 |