| NPI | 1295143485 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 8579TG) |
| Additional Taxonomies | 152WP0200X Optometrist, Pediatrics (Licence: PA OEG002988) |
| Enumeration Date | 2014-07-31 |
| Last Update Date | 2017-02-23 |