| NPI | 1760731434 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA 14690) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY TUV007892-1) |
| Enumeration Date | 2012-09-10 |
| Last Update Date | 2022-04-07 |