| NPI | 1073800686 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA OPT14347-TLG) |
| Additional Taxonomies | 152WV0400X Optometrist Vision Therapy (Licence: CA 14347TLG) |
| Enumeration Date | 2011-07-03 |
| Last Update Date | 2021-12-23 |