| NPI | 1427293638 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 8367) | 
| Additional Taxonomies | 152W00000X Optometrist (Licence: IL 046.010169) | 
| Enumeration Date | 2008-12-03 | 
| Last Update Date | 2018-01-05 |