| NPI | 1619923794 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: UT 372443-9934) |
| Additional Taxonomies | 152WC0802X Optometrist, Corneal and Contact Management (Licence: UT 372443-8908) |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2007-07-08 |