| NPI | 1376613968 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: GA 001761) |
| Additional Taxonomies | 152WC0802X Optometrist Corneal and Contact Management (Licence: GA 001761) |
| 152WP0200X Optometrist Pediatrics (Licence: GA 001761) | |
| 133NN1002X Nutritionist Nutrition, Education (Licence: GA 1761) | |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2012-11-16 |