| NPI | 1023264314 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA 35394) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: WA 3545) |
| Enumeration Date | 2008-08-18 |
| Last Update Date | 2023-08-03 |