| NPI | 1215509658 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 10209) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: VA 0618003045) |
| Enumeration Date | 2021-07-14 |
| Last Update Date | 2026-06-03 |