| NPI | 1649505611 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA OPT 13847 TLG) |
| Additional Taxonomies | 152WC0802X Optometrist, Corneal and Contact Management (Licence: CA OPT 13847 TLG) |
| Enumeration Date | 2009-10-08 |
| Last Update Date | 2009-10-08 |