| NPI | 1366119141 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152WP0200X Optometrist Pediatrics (Licence: MI 4901005569) |
| Additional Taxonomies | 152WV0400X Optometrist Vision Therapy (Licence: MI 4901005569) |
| Enumeration Date | 2021-08-27 |
| Last Update Date | 2021-08-27 |