| NPI | 1245510379 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AZ OPT-002252) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CA 14299) |
| Enumeration Date | 2011-08-21 |
| Last Update Date | 2020-02-27 |