| NPI | 1760426928 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA 9020) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: WA 3327) |
| 152W00000X Optometrist (Licence: TX 4106T) | |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2007-07-16 |