| NPI | 1104588912 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 10421T) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TX 1042T) |
| Enumeration Date | 2021-10-08 |
| Last Update Date | 2021-11-10 |