| NPI | 1619330263 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IL 046.011259) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CA 33358) |
| Enumeration Date | 2016-03-31 |
| Last Update Date | 2020-06-25 |