| NPI | 1124575410 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA 34429TLG) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TX 9069T) |
| Enumeration Date | 2016-09-05 |
| Last Update Date | 2019-10-21 |