| NPI | 1407966765 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: UT 105610199934) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: AR 2555) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2018-02-21 |