| NPI | 1083604664 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: SC 1921) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TX 6163T) |
| Enumeration Date | 2005-10-25 |
| Last Update Date | 2026-05-15 |