| NPI | 1205216934 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 9328TG) | 
| Additional Taxonomies | 152W00000X Optometrist (Licence: FL OPC5051) | 
| Enumeration Date | 2015-06-08 | 
| Last Update Date | 2018-03-17 |