| NPI | 1194379206 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 10468) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: AL T-240-TA-B47) |
| Enumeration Date | 2019-07-26 |
| Last Update Date | 2022-03-15 |