| NPI | 1316618481 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA 35072) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OR ATI4600) |
| Enumeration Date | 2021-09-27 |
| Last Update Date | 2022-12-15 |