| NPI | 1043651425 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA OPT 15061 TLG) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: UT 8702591-9934) |
| Enumeration Date | 2013-07-12 |
| Last Update Date | 2014-07-18 |