| NPI | 1457661324 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 8389T) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NM 616) |
| Enumeration Date | 2010-10-13 |
| Last Update Date | 2016-09-23 |