| NPI | 1417485624 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA 33671) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CA 33671TLG) |
| Enumeration Date | 2017-06-01 |
| Last Update Date | 2021-09-11 |