| NPI | 1013205905 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA 14336) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: UT 8021476-9934) |
| 152WL0500X Optometrist, Low Vision Rehabilitation (Licence: CA 14336) | |
| Enumeration Date | 2011-07-13 |
| Last Update Date | 2017-11-07 |