| NPI | 1619011665 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 6488TG) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MN 2935) |
| Enumeration Date | 2007-02-16 |
| Last Update Date | 2020-03-18 |