| NPI | 1174907976 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA 33411-TLG) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: AZ 2050) |
| Enumeration Date | 2015-07-13 |
| Last Update Date | 2018-02-22 |