| NPI | 1194891366 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 5659T) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: LA 1236-403T) |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2007-07-08 |