| NPI | 1609819614 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA OPT14382-TPL) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MA 4527) |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2017-05-04 |