| NPI | 1760504674 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NC 2052) |
| Additional Taxonomies | 152WP0200X Optometrist Pediatrics (Licence: NC 2052) |
| 152WV0400X Optometrist Vision Therapy (Licence: NC 2052) | |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2022-12-30 |