| NPI | 1710112511 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 8622T) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY TUV006912) |
| Enumeration Date | 2009-05-21 |
| Last Update Date | 2017-11-27 |