| NPI | 1891075628 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: LA 1624-657T) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TX 7758T) |
| Enumeration Date | 2011-08-24 |
| Last Update Date | 2016-07-18 |