| NPI | 1275197519 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA OPT34243-TLG) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY TUV008999-01) |
| Enumeration Date | 2019-04-23 |
| Last Update Date | 2022-04-25 |