| NPI | 1043565435 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA 33903TLG) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY TUV007879) |
| Enumeration Date | 2012-07-20 |
| Last Update Date | 2020-10-28 |