| NPI | 1528609096 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AZ OPT-002486) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CA 34417) |
| Enumeration Date | 2019-10-04 |
| Last Update Date | 2021-06-16 |