| NPI | 1508814070 |
|---|---|
| Former Name | TINA MARIE LANDRY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 7187TG) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CT 2603) |
| 152W00000X Optometrist (Licence: FL 3911) | |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2014-05-12 |