| NPI | 1669784088 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA 15113 TLG) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OR 3353AT) |
| Enumeration Date | 2010-07-14 |
| Last Update Date | 2017-01-19 |