| NPI | 1639726680 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA 34460) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: AZ OPT-002381) |
| Enumeration Date | 2019-08-23 |
| Last Update Date | 2020-10-06 |