| NPI | 1396150389 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 10129TG) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: FL OPC5058) |
| 152W00000X Optometrist (Licence: PA OEG002953) | |
| Enumeration Date | 2014-06-27 |
| Last Update Date | 2022-03-21 |