| NPI | 1619353786 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: LA 1799-733AT) |
| Additional Taxonomies | 152WL0500X Optometrist, Low Vision Rehabilitation (Licence: LA 1799-733AT) |
| Enumeration Date | 2015-07-30 |
| Last Update Date | 2020-10-01 |