| NPI | 1194867069 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL 0PC3791) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TX 07017T) |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2013-06-05 |