| NPI | 1861640658 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: UT 7229395-9934) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CA 14072) |
| Enumeration Date | 2008-09-04 |
| Last Update Date | 2019-12-23 |