| NPI | 1053841478 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA OPT33685-TLG) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY TUV009101-01) |
| Enumeration Date | 2017-06-18 |
| Last Update Date | 2021-04-15 |