| NPI | 1194073528 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MS 913) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TX 8034T) |
| Enumeration Date | 2012-08-15 |
| Last Update Date | 2016-11-15 |