| NPI | 1821048802 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 6495TG) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CA 12775 TPA) |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2012-09-27 |