| NPI | 1558558437 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 7531T) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: HI OD-612) |
| 152W00000X Optometrist (Licence: WA OD00003747) | |
| 152W00000X Optometrist (Licence: FL OPC 4256) | |
| Enumeration Date | 2007-09-25 |
| Last Update Date | 2012-09-10 |