| NPI | 1023119302 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 2744T) |
| Additional Taxonomies | 152WC0802X Optometrist, Corneal and Contact Management (Licence: TX 2744T) |
| 152WS0006X Optometrist, Sports Vision (Licence: TX 2744T) | |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2008-09-17 |