| NPI | 1972012797 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA OPT33917) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: AZ 2190) |
| Enumeration Date | 2017-09-25 |
| Last Update Date | 2018-08-30 |