| NPI | 1942495122 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA OPT13775TLG) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY TUV007162) |
| Enumeration Date | 2007-09-11 |
| Last Update Date | 2019-10-04 |