| NPI | 1598318412 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA 34764) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG003585) |
| Enumeration Date | 2019-07-19 |
| Last Update Date | 2021-01-29 |