| NPI | 1114125085 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA OPT13335) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY 007259) |
| Enumeration Date | 2007-07-03 |
| Last Update Date | 2015-10-22 |