| NPI | 1386648731 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 5166TG) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CA 10639TPA) |
| Enumeration Date | 2005-06-13 |
| Last Update Date | 2019-12-06 |