| NPI | 1518218189 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NV 907) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CA OPT14495 TLG) |
| Enumeration Date | 2012-09-24 |
| Last Update Date | 2020-12-21 |