| NPI | 1679982169 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 8742T) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TN 3166) |
| Enumeration Date | 2014-08-08 |
| Last Update Date | 2016-07-02 |