| NPI | 1285087593 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA 33928TLG) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG003256) |
| 152W00000X Optometrist (Licence: WI 3431-35) | |
| Enumeration Date | 2016-07-21 |
| Last Update Date | 2021-06-22 |