| NPI | 1073677613 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA 10667 TPG) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NM 483) |
| Enumeration Date | 2006-12-20 |
| Last Update Date | 2023-03-07 |