| NPI | 1205288370 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA OPT33473TLG) |
| Additional Taxonomies | 152WS0006X Optometrist Sports Vision (Licence: CA OPT33473TLG) |
| Enumeration Date | 2016-07-12 |
| Last Update Date | 2019-12-29 |