| NPI | 1104350651 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA 33695) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: AZ 2161) |
| Enumeration Date | 2017-04-11 |
| Last Update Date | 2022-01-26 |