| NPI | 1376064998 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 9175) |
| Additional Taxonomies | 152WS0006X Optometrist, Sports Vision (Licence: TX 9175) |
| 152WV0400X Optometrist, Vision Therapy (Licence: TX 9175) | |
| 152WX0102X Optometrist, Occupational Vision (Licence: TX 9175) | |
| 152WP0200X Optometrist, Pediatrics (Licence: TX 9175) | |
| 152WL0500X Optometrist, Low Vision Rehabilitation (Licence: TX 9175) | |
| Enumeration Date | 2017-07-05 |
| Last Update Date | 2024-02-20 |