| NPI | 1952411969 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152WV0400X Optometrist, Vision Therapy (Licence: GA 2355) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: GA 2355) |
| 152W00000X Optometrist (Licence: SC 1440) | |
| 152WV0400X Optometrist, Vision Therapy (Licence: SC 1440) | |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2022-10-07 |