| NPI | 1801112461 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA 14118TLG) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: HI 704) |
| Enumeration Date | 2010-04-07 |
| Last Update Date | 2011-07-15 |