| NPI | 1730572744 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OR ATI1726) |
| Additional Taxonomies | 152WC0802X Optometrist, Corneal and Contact Management (Licence: OR 1726T) |
| Enumeration Date | 2015-03-16 |
| Last Update Date | 2020-09-02 |