| NPI | 1003046038 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 7385T) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: WA 60092625) |
| Enumeration Date | 2009-07-24 |
| Last Update Date | 2021-02-11 |