| NPI | 1497161236 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA 15147) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: WA 60594144) |
| Enumeration Date | 2014-07-01 |
| Last Update Date | 2020-11-03 |