NPI | 1962835017 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: SD 712) |
Additional Taxonomies | 152W00000X Optometrist (Licence: KY 1941DT) |
152WV0400X Optometrist, Vision Therapy (Licence: SD 712) | |
152WV0400X Optometrist, Vision Therapy (Licence: KY 1941DT) | |
Enumeration Date | 2013-08-13 |
Last Update Date | 2019-05-20 |