| NPI | 1619162203 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152WP0200X Optometrist Pediatrics (Licence: GA OPT002490) |
| Additional Taxonomies | 152WS0006X Optometrist Sports Vision (Licence: GA OPT002490) |
| 152WV0400X Optometrist Vision Therapy (Licence: GA OPT002490) | |
| 152W00000X Optometrist (Licence: GA OPT002490) | |
| 152W00000X Optometrist (Licence: FL OPC4271) | |
| Enumeration Date | 2007-09-07 |
| Last Update Date | 2009-11-13 |