| NPI | 1982618682 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA 11246T) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: AZ 1953) |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2023-03-07 |