NPI | 1326328790 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 152W00000X Optometrist (Licence: CA OPT 15196 TLG) |
Additional Taxonomies | 152W00000X Optometrist (Licence: VA 0618002078) |
152W00000X Optometrist (Licence: WA OD 60237279) | |
Enumeration Date | 2011-08-17 |
Last Update Date | 2017-02-24 |