| NPI | 1952663924 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MI 4901004706) |
| Additional Taxonomies | 152WC0802X Optometrist, Corneal and Contact Management (Licence: MI 4901004706) |
| 152WS0006X Optometrist, Sports Vision (Licence: MI 4901004706) | |
| 152WV0400X Optometrist, Vision Therapy (Licence: MI 4901004706) | |
| Enumeration Date | 2012-06-14 |
| Last Update Date | 2013-09-17 |