| NPI | 1619698388 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IA 114538) |
| Additional Taxonomies | 152WV0400X Optometrist, Vision Therapy (Licence: TX 10685) |
| Enumeration Date | 2022-09-09 |
| Last Update Date | 2023-11-28 |