| NPI | 1467802868 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MO 2016017809) |
| Additional Taxonomies | 152WV0400X Optometrist, Vision Therapy (Licence: MO 2016017809) |
| Enumeration Date | 2016-06-16 |
| Last Update Date | 2016-06-16 |