| NPI | 1831313808 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA 10548T) |
| Additional Taxonomies | 152WL0500X Optometrist, Low Vision Rehabilitation (Licence: CA 10548T) |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2007-10-05 |