| NPI | 1245751742 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 9191TG) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: GA OPT003031) |
| Enumeration Date | 2017-07-05 |
| Last Update Date | 2020-12-17 |