| NPI | 1598147100 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152WC0802X Optometrist, Corneal and Contact Management (Licence: OR 3612ATI) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OR 3612ATI) |
| 152WL0500X Optometrist, Low Vision Rehabilitation (Licence: OR 3612ATI) | |
| Enumeration Date | 2015-06-19 |
| Last Update Date | 2020-05-19 |