| NPI | 1205668068 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 11523) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: GA OPT003606) |
| Enumeration Date | 2024-08-19 |
| Last Update Date | 2026-05-04 |