| NPI | 1679988257 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA 33353 - TLG) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: VA 0618002344) |
| Enumeration Date | 2014-06-23 |
| Last Update Date | 2017-01-11 |