| NPI | 1912312430 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 8572T) |
| Additional Taxonomies | 152WV0400X Optometrist, Vision Therapy (Licence: TX 8572T) |
| 152WP0200X Optometrist, Pediatrics (Licence: TX 8572T) | |
| Enumeration Date | 2014-06-23 |
| Last Update Date | 2014-10-06 |