| NPI | 1659892669 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA 33948) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: ID 100408) |
| Enumeration Date | 2017-06-29 |
| Last Update Date | 2021-12-07 |