| NPI | 1043964232 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AZ 002539) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CA 34833) |
| Enumeration Date | 2022-02-08 |
| Last Update Date | 2023-09-26 |