| NPI | 1770819070 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA 14375) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: FL OPC4477) |
| Enumeration Date | 2009-10-22 |
| Last Update Date | 2020-07-07 |