| NPI | 1053084343 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WA OD61291177) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TX 10219T) |
| Enumeration Date | 2021-08-01 |
| Last Update Date | 2025-01-14 |