| NPI | 1124542725 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 9661) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY 008658) |
| Enumeration Date | 2017-07-26 |
| Last Update Date | 2021-03-25 |