| NPI | 1497483002 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MI 4901005640) |
| Additional Taxonomies | 152WV0400X Optometrist, Vision Therapy (Licence: MI 4901005640) |
| 152WP0200X Optometrist, Pediatrics (Licence: MI 4901005640) | |
| Enumeration Date | 2022-08-11 |
| Last Update Date | 2025-12-26 |