| NPI | 1366859829 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CO OPT.0003074) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TX 8407T) |
| Enumeration Date | 2014-07-16 |
| Last Update Date | 2014-09-22 |