| NPI | 1962453423 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 4899TG) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: LA 1135) |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2016-09-16 |