| NPI | 1942793336 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA 34130) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: UT 10832957-9934) |
| 152W00000X Optometrist (Licence: NV 1015) | |
| Enumeration Date | 2018-06-11 |
| Last Update Date | 2021-12-27 |