| NPI | 1043285356 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CO CO2680) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TX 03714TG) |
| 152W00000X Optometrist (Licence: TX 3714TG) | |
| Enumeration Date | 2006-02-21 |
| Last Update Date | 2012-10-25 |