| NPI | 1700512670 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA OPT35772-TLG) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG003924) |
| Enumeration Date | 2022-07-25 |
| Last Update Date | 2025-01-06 |