| NPI | 1396572806 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA 35812) |
| Additional Taxonomies | 171000000X Military Health Care Provider |
| 152W00000X Optometrist (Licence: VA 0618003426) | |
| Enumeration Date | 2024-09-18 |
| Last Update Date | 2024-09-18 |