NPI | 1124688189 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: CA 34849) |
Additional Taxonomies | 152W00000X Optometrist (Licence: MO 2019018013) |
Enumeration Date | 2019-06-20 |
Last Update Date | 2021-07-21 |