| NPI | 1407108624 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 8087T) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY TUV008069) |
| Enumeration Date | 2012-10-11 |
| Last Update Date | 2014-04-11 |