| NPI | 1689859555 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 7179T) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OH 5727) |
| Enumeration Date | 2008-01-09 |
| Last Update Date | 2008-09-29 |