| NPI | 1972244218 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA 35115) |
| Additional Taxonomies | 152WS0006X Optometrist, Sports Vision (Licence: CA 35115) |
| 152WV0400X Optometrist, Vision Therapy (Licence: CA 35115) | |
| Enumeration Date | 2022-04-01 |
| Last Update Date | 2022-04-01 |