| NPI | 1386059053 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: KS 1987) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MN 3386) |
| 152WV0400X Optometrist, Vision Therapy (Licence: TX 8861T) | |
| Enumeration Date | 2014-06-21 |
| Last Update Date | 2020-10-27 |