| NPI | 1023108743 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA 14189) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MO 2000167780) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2013-02-08 |