| NPI | 1578511549 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IA 02196) |
| Additional Taxonomies | 152WV0400X Optometrist, Vision Therapy (Licence: IA 02196) |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2011-03-11 |