| NPI | 1124024294 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA OPT 14355 TPL) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MO 2004020414) |
| Enumeration Date | 2005-06-23 |
| Last Update Date | 2013-10-23 |