| NPI | 1124343561 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 7923T) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IL 046010315) |
| Enumeration Date | 2010-03-29 |
| Last Update Date | 2012-10-15 |