| NPI | 1174864318 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CO 0003736) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: VA 0618002360) |
| Enumeration Date | 2013-03-13 |
| Last Update Date | 2023-06-13 |