| NPI | 1609938398 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: HI OD 644) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TX 6767 TG) |
| Enumeration Date | 2006-12-15 |
| Last Update Date | 2009-10-19 |