| NPI | 1023000304 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX tx4167tg) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX tx4167tg) |
| Enumeration Date | 2005-08-22 |
| Last Update Date | 2014-10-08 |