| NPI | 1174605257 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 9824T) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: VA 0618001412) |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2022-03-05 |