| NPI | 1518190123 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA 10626T) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: WA OD 60003995) |
| 152W00000X Optometrist (Licence: OR 2555T) | |
| Enumeration Date | 2009-08-30 |
| Last Update Date | 2018-03-17 |