| NPI | 1801984315 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA 11730T) |
| Additional Taxonomies | 152WL0500X Optometrist Low Vision Rehabilitation (Licence: CA 11730T) |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2007-07-09 |