| NPI | 1013295252 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA 14107) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NE 1356) |
| Enumeration Date | 2011-07-21 |
| Last Update Date | 2012-10-17 |