| NPI | 1861164642 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA 35009) |
| Additional Taxonomies | 152WP0200X Optometrist Pediatrics (Licence: CA 35009) |
| 152WV0400X Optometrist Vision Therapy (Licence: CA 35009) | |
| Enumeration Date | 2021-09-30 |
| Last Update Date | 2022-08-25 |