| NPI | 1649392754 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 152WL0500X Optometrist, Low Vision Rehabilitation (Licence: MD TA2029) | 
| Additional Taxonomies | 152WL0500X Optometrist, Low Vision Rehabilitation (Licence: CA 12343T) | 
| Enumeration Date | 2007-04-06 | 
| Last Update Date | 2007-07-08 |