| NPI | 1629072533 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA 08887TLG) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: AZ 721) |
| 152W00000X Optometrist (Licence: UT 113376-9934) | |
| 152WL0500X Optometrist, Low Vision Rehabilitation (Licence: CA 08887TLG) | |
| Enumeration Date | 2005-06-08 |
| Last Update Date | 2023-03-07 |