| NPI | 1659708295 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA 34405) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MD TA2386) |
| 152W00000X Optometrist (Licence: NJ 27OA00650700) | |
| Enumeration Date | 2013-09-27 |
| Last Update Date | 2021-09-28 |