| NPI | 1124478128 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA 34419TLG) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MD TA2533) |
| Enumeration Date | 2016-06-21 |
| Last Update Date | 2020-11-19 |