| NPI | 1275783185 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 7687 T) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CA 12605T) |
| Enumeration Date | 2008-09-27 |
| Last Update Date | 2013-02-04 |