| NPI | 1447229521 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 152W00000X Optometrist (Licence: PR 143) |
| Additional Taxonomies | 152WV0400X Optometrist Vision Therapy (Licence: PR 143) |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2007-07-08 |