| NPI | 1790097301 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 7766TG) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: VA 0618001965) |
| Enumeration Date | 2010-07-12 |
| Last Update Date | 2011-09-07 |