| NPI | 1942505151 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: HI 738) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CA 14109) |
| Enumeration Date | 2011-01-19 |
| Last Update Date | 2015-11-18 |