| NPI | 1093197071 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 8741)  | 
| Additional Taxonomies | 152W00000X Optometrist (Licence: TX 8741T)  | 
| Enumeration Date | 2015-06-25 | 
| Last Update Date | 2022-05-12 |