| 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 |