| NPI | 1033225677 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MO T03365) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TX 5402T) |
| 152W00000X Optometrist (Licence: WA 3340) | |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2007-07-08 |