| NPI | 1205127834 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 7700TG) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: GA OPT002592) |
| Enumeration Date | 2011-05-01 |
| Last Update Date | 2016-11-18 |