| NPI | 1467648873 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AK 302) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TX 7090) |
| Enumeration Date | 2007-09-19 |
| Last Update Date | 2014-10-02 |