| NPI | 1831231505 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 4399) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: FL 1678) |
| 152W00000X Optometrist (Licence: GA 955) | |
| Enumeration Date | 2007-02-12 |
| Last Update Date | 2007-07-08 |