| NPI | 1073650719 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA 10790T) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CT 2538) |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2007-07-08 |