| NPI | 1205124732 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 152WP0200X Optometrist, Pediatrics (Licence: TX 7712TG)  | 
| Additional Taxonomies | 152W00000X Optometrist (Licence: TX 7712TG)  | 
| 152WC0802X Optometrist, Corneal and Contact Management (Licence: TX 7712TG)  | |
| 152WV0400X Optometrist, Vision Therapy (Licence: TX 7712TG)  | |
| Enumeration Date | 2011-07-19 | 
| Last Update Date | 2012-07-17 |