| NPI | 1972902823 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA OPT 15013 TLG) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IL 046.010840) |
| Enumeration Date | 2014-08-16 |
| Last Update Date | 2018-08-07 |