| NPI | 1154569796 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: UT 7671967-9934) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OR 3297ATI) |
| 152W00000X Optometrist (Licence: TX 7211T) | |
| Enumeration Date | 2009-02-03 |
| Last Update Date | 2010-07-08 |