| NPI | 1629487608 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AZ 1994) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CA 14983) |
| Enumeration Date | 2014-08-04 |
| Last Update Date | 2014-12-21 |