| NPI | 1457793994 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: LA 1652-686T) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TX 8208T) |
| Enumeration Date | 2013-07-25 |
| Last Update Date | 2020-07-16 |