| NPI | 1649590431 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 7841TG) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TX 7841T) |
| Enumeration Date | 2010-06-03 |
| Last Update Date | 2014-08-04 |