| NPI | 1578555884 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MI 4901004033) |
| Additional Taxonomies | 152WP0200X Optometrist, Pediatrics (Licence: MI 4901004033) |
| 152WS0006X Optometrist, Sports Vision (Licence: MI 4901004033) | |
| 152WV0400X Optometrist, Vision Therapy (Licence: MI 4901004033) | |
| 152WX0102X Optometrist, Occupational Vision (Licence: MI 4901004033) | |
| Enumeration Date | 2005-08-22 |
| Last Update Date | 2007-11-20 |