| NPI | 1306273420 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 9590TG) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IL 046011122) |
| 152W00000X Optometrist (Licence: NY 008079) | |
| Enumeration Date | 2013-10-03 |
| Last Update Date | 2020-09-21 |