| NPI | 1477960268 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AZ 1993) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TX 8397T) |
| Enumeration Date | 2014-07-14 |
| Last Update Date | 2014-07-14 |