| NPI | 1922430495 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA 14978) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG002795) |
| Enumeration Date | 2013-08-06 |
| Last Update Date | 2021-11-29 |