| NPI | 1417206913 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NC 2294) |
| Additional Taxonomies | 152WV0400X Optometrist, Vision Therapy (Licence: NC 2294) |
| Enumeration Date | 2012-08-30 |
| Last Update Date | 2015-05-07 |