| NPI | 1568575561 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 6060TG) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: LA 1607-640T) |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2012-06-11 |