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 |