| NPI | 1053588921 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 07146T) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: GA OPT002412) |
| Enumeration Date | 2008-05-09 |
| Last Update Date | 2008-08-26 |