| NPI | 1497031660 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA 14327 TLG) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: AZ 002541) |
| Enumeration Date | 2011-11-01 |
| Last Update Date | 2021-10-18 |