| NPI | 1669761649 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MD TA2234) |
| Additional Taxonomies | 152WV0400X Optometrist, Vision Therapy (Licence: MD TA2234) |
| Enumeration Date | 2011-03-30 |
| Last Update Date | 2014-09-29 |