| NPI | 1972697597 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA 13226T) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: WA 3814TX) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2013-09-23 |