| NPI | 1205380243 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NC 2485) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TX 9063) |
| Enumeration Date | 2016-08-08 |
| Last Update Date | 2024-10-08 |