NPI | 1205084787 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 152W00000X Optometrist (Licence: CA 13802) |
Additional Taxonomies | 152W00000X Optometrist (Licence: PA oeg002144) |
152W00000X Optometrist (Licence: AZ OPT-002747) | |
Enumeration Date | 2008-09-08 |
Last Update Date | 2024-05-24 |