| NPI | 1730343534 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 8112T) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CA OPT13919) |
| 152W00000X Optometrist (Licence: FL OPC4315) | |
| Enumeration Date | 2008-07-11 |
| Last Update Date | 2012-12-14 |