| NPI | 1508111709 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA 14789) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CT 2935) |
| Enumeration Date | 2012-07-13 |
| Last Update Date | 2018-08-09 |