| NPI | 1437142890 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NC 1644) |
| Additional Taxonomies | 152WV0400X Optometrist, Vision Therapy (Licence: NC 1644) |
| Enumeration Date | 2005-08-31 |
| Last Update Date | 2021-08-31 |