| NPI | 1932168804 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AK 220) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TX 6532T) |
| Enumeration Date | 2006-03-20 |
| Last Update Date | 2018-02-17 |