| NPI | 1740462993 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 7521T) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MI 4901004445) |
| Enumeration Date | 2007-11-29 |
| Last Update Date | 2014-07-08 |