| NPI | 1467887786 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152WV0400X Optometrist, Vision Therapy (Licence: AZ 1961) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TN 3130) |
| 152WP0200X Optometrist, Pediatrics (Licence: AZ 1961) | |
| 152WS0006X Optometrist, Sports Vision (Licence: AZ 1961) | |
| 152W00000X Optometrist (Licence: AZ 1961) | |
| 152WL0500X Optometrist, Low Vision Rehabilitation (Licence: AZ 1961) | |
| Enumeration Date | 2013-09-05 |
| Last Update Date | 2015-04-24 |