| NPI | 1225701733 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA OPT35413-TLG) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG003822) |
| 152W00000X Optometrist (Licence: WV 3013-IOD) | |
| Enumeration Date | 2021-07-29 |
| Last Update Date | 2023-06-18 |