| NPI | 1023677424 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 10920) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MI 4901005386) |
| 152WC0802X Optometrist, Corneal and Contact Management (Licence: TX 10920) | |
| 152WL0500X Optometrist, Low Vision Rehabilitation (Licence: TX 10920) | |
| 152WP0200X Optometrist, Pediatrics (Licence: TX 10920) | |
| 152WS0006X Optometrist, Sports Vision (Licence: TX 10920) | |
| 152WX0102X Optometrist, Occupational Vision (Licence: TX 10920) | |
| Enumeration Date | 2019-06-10 |
| Last Update Date | 2025-05-23 |