| NPI | 1558714196 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CO 3372) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CA 33772TLG) |
| 152W00000X Optometrist (Licence: CO Opt.0003372) | |
| 152W00000X Optometrist (Licence: NJ 27OA00667300) | |
| 152WP0200X Optometrist, Pediatrics (Licence: CO Opt.0003372) | |
| 152WP0200X Optometrist, Pediatrics (Licence: CA 33772TLG) | |
| 152WV0400X Optometrist, Vision Therapy (Licence: CO Opt.0003372) | |
| 152WV0400X Optometrist, Vision Therapy (Licence: CA 33772TLG) | |
| 152WV0400X Optometrist, Vision Therapy (Licence: NJ 27OA00667300) | |
| Enumeration Date | 2016-07-19 |
| Last Update Date | 2022-04-08 |