| NPI | 1821155300 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA 10148T) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NV 993) |
| Enumeration Date | 2007-01-03 |
| Last Update Date | 2019-04-05 |