| NPI | 1497030555 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA 15209 TLG) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OR 3593 ATI) |
| Enumeration Date | 2011-10-19 |
| Last Update Date | 2015-12-16 |