| NPI | 1548512874 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: HI OD-830) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CA 33362) |
| 152W00000X Optometrist (Licence: WA OD60574434) | |
| Enumeration Date | 2012-10-10 |
| Last Update Date | 2020-08-21 |