| NPI | 1881035798 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NE 1392) |
| Additional Taxonomies | 152WV0400X Optometrist, Vision Therapy (Licence: NE 1392) |
| Enumeration Date | 2013-07-09 |
| Last Update Date | 2015-01-19 |