| NPI | 1033559919 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 11520) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG002811) |
| Enumeration Date | 2013-06-25 |
| Last Update Date | 2025-10-24 |