| NPI | 1588659213 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AZ AZ1300) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CA 12477T) |
| Enumeration Date | 2005-09-19 |
| Last Update Date | 2013-05-16 |