| NPI | 1164442729 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 5128TG) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX 5128TG) |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2015-12-04 |