| NPI | 1871643718 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MO 2003026559) |
| Additional Taxonomies | 152WP0200X Optometrist, Pediatrics (Licence: MO 2003026559) |
| 152WV0400X Optometrist, Vision Therapy (Licence: MO 2003206559) | |
| Enumeration Date | 2007-01-11 |
| Last Update Date | 2022-11-28 |