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 |