| NPI | 1063848984 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NE 1402) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TX 8295) |
| Enumeration Date | 2013-09-24 |
| Last Update Date | 2020-02-26 |