| NPI | 1053921890 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 10080) |
| Additional Taxonomies | 152WV0400X Optometrist, Vision Therapy (Licence: TX 10080) |
| Enumeration Date | 2020-08-06 |
| Last Update Date | 2020-08-06 |