| NPI | 1609979491 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 7202T) | 
| Additional Taxonomies | 152W00000X Optometrist (Licence: MS 726) | 
| Enumeration Date | 2006-09-07 | 
| Last Update Date | 2008-10-07 |