| NPI | 1679022453 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA 33579) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY 008507) |
| Enumeration Date | 2016-09-22 |
| Last Update Date | 2022-02-11 |