| NPI | 1851369367 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL 4249) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TX 06730T) |
| 152W00000X Optometrist (Licence: LA 1421) | |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2012-10-19 |