| NPI | 1356755755 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA 15095TLG) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY 008152) |
| Enumeration Date | 2014-06-13 |
| Last Update Date | 2015-08-20 |