| NPI | 1851362453 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OR 2599ATI) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CA OPT11282TPA) |
| Enumeration Date | 2006-01-31 |
| Last Update Date | 2015-01-13 |