| NPI | 1548622426 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152WV0400X Optometrist, Vision Therapy (Licence: MI 4901004973) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MI 4901004973) |
| Enumeration Date | 2016-03-22 |
| Last Update Date | 2021-03-31 |