| NPI | 1417352238 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 8775TG) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CA OPT15032TLG) |
| Enumeration Date | 2014-10-23 |
| Last Update Date | 2020-01-27 |