| NPI | 1548607419 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NC 2369) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: SC 1771) |
| 152WL0500X Optometrist, Low Vision Rehabilitation (Licence: SC 1771) | |
| Enumeration Date | 2013-05-31 |
| Last Update Date | 2022-01-28 |