| NPI | 1316013170 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 6811TG) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OH 5687-Ther.) |
| Enumeration Date | 2006-11-24 |
| Last Update Date | 2013-04-17 |