| NPI | 1922556786 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA 34694) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CT 3012) |
| Enumeration Date | 2016-09-21 |
| Last Update Date | 2022-01-26 |