| NPI | 1699885830 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NV 756) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MA 4589) |
| 152WV0400X Optometrist Vision Therapy (Licence: CA 11987T) | |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2021-07-21 |