| NPI | 1669586590 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: VA 061800200) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CA OPT8329TPA) |
| 225X00000X Occupational Therapist (Licence: VA 0119005380) | |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2011-12-07 |