| NPI | 1548283203 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA 13228T) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OH OH5293) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2007-08-28 |