| NPI | 1063678704 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 7356T) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: LA 1565-597T) |
| Enumeration Date | 2008-08-01 |
| Last Update Date | 2025-04-14 |