| NPI | 1295967206 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA 13909) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: AZ 1708) |
| Enumeration Date | 2009-08-10 |
| Last Update Date | 2022-02-02 |