| NPI | 1205417649 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA 34940) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: AZ OPT-002490) |
| Enumeration Date | 2021-04-17 |
| Last Update Date | 2022-12-07 |