| NPI | 1720008535 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MT 604) |
| Additional Taxonomies | 152WL0500X Optometrist, Low Vision Rehabilitation (Licence: MT 604) |
| 152WV0400X Optometrist, Vision Therapy (Licence: MT 604) | |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2008-01-28 |