| NPI | 1336242254 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA 12612) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: WA OD00004067) |
| Enumeration Date | 2006-09-06 |
| Last Update Date | 2019-02-26 |