NPI | 1164524476 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 152W00000X Optometrist (Licence: CA 12850TPA) |
Additional Taxonomies | 152WP0200X Optometrist, Pediatrics (Licence: CA 12850TPA) |
Enumeration Date | 2006-09-05 |
Last Update Date | 2021-11-30 |