| NPI | 1508962390 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CO 1254) |
| Additional Taxonomies | 152WV0400X Optometrist, Vision Therapy (Licence: CO 1254) |
| Enumeration Date | 2006-09-16 |
| Last Update Date | 2009-08-14 |