| NPI | 1902191281 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA 14101T) |
| Additional Taxonomies | 152WL0500X Optometrist, Low Vision Rehabilitation (Licence: CA 14101T) |
| Enumeration Date | 2011-06-14 |
| Last Update Date | 2018-06-05 |