| NPI | 1063078640 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA 34214) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TX 9449T) |
| Enumeration Date | 2019-05-19 |
| Last Update Date | 2019-06-30 |