| NPI | 1659924801 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA OPT-34860) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG003580) |
| Enumeration Date | 2019-07-17 |
| Last Update Date | 2022-01-02 |