| NPI | 1689807836 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: VA 0618000393) |
| Additional Taxonomies | 152WV0400X Optometrist, Vision Therapy (Licence: VA 0618000393) |
| 225X00000X Occupational Therapist (Licence: VA 0119003841) | |
| Enumeration Date | 2009-09-03 |
| Last Update Date | 2009-09-03 |