| NPI | 1558674846 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 7569T) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CA 14353TLG) |
| Enumeration Date | 2010-07-15 |
| Last Update Date | 2019-03-12 |