| NPI | 1215145065 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA 12307) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: WA 3874) |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2015-05-26 |