| NPI | 1346251386 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CO 2621) |
| Additional Taxonomies | 152WC0802X Optometrist, Corneal and Contact Management (Licence: CO 2621) |
| 152WL0500X Optometrist, Low Vision Rehabilitation (Licence: CO 2621) | |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2019-02-12 |