| NPI | 1477502789 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: GA OPT001403) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: SC 1075) |
| 152WL0500X Optometrist, Low Vision Rehabilitation (Licence: GA OPT001403) | |
| 152WL0500X Optometrist, Low Vision Rehabilitation (Licence: SC 1075) | |
| 152WV0400X Optometrist, Vision Therapy (Licence: GA OPT001403) | |
| 152WV0400X Optometrist, Vision Therapy (Licence: SC 1075) | |
| Enumeration Date | 2006-05-06 |
| Last Update Date | 2008-09-17 |