| NPI | 1477696128 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152WC0802X Optometrist, Corneal and Contact Management (Licence: MI 4901004176) |
| Additional Taxonomies | 152WP0200X Optometrist, Pediatrics (Licence: MI 4901004176) |
| 152WX0102X Optometrist, Occupational Vision (Licence: MI 4901004176) | |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2007-07-08 |