| 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 |