| NPI | 1407858962 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 6743TG) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TX 6743T) |
| Enumeration Date | 2005-08-15 |
| Last Update Date | 2024-05-10 |