| NPI | 1396717047 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 8813) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: GA OPT002715) |
| 152W00000X Optometrist (Licence: TX 8813T) | |
| 152WP0200X Optometrist, Pediatrics (Licence: OH 5427) | |
| 152WP0200X Optometrist, Pediatrics (Licence: FL OPC4758) | |
| Enumeration Date | 2006-02-06 |
| Last Update Date | 2022-05-10 |