| NPI | 1093395147 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OK 3119) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TX 10362T) |
| Enumeration Date | 2021-04-13 |
| Last Update Date | 2022-06-04 |