| NPI | 1417479718 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: SC 1998) |
| Additional Taxonomies | 152WP0200X Optometrist, Pediatrics (Licence: SC 1998) |
| 152WV0400X Optometrist, Vision Therapy (Licence: SC 1998) | |
| Enumeration Date | 2017-07-09 |
| Last Update Date | 2017-07-09 |