| NPI | 1437998119 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 11208TG) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OH OPT.007298) |
| Enumeration Date | 2024-05-22 |
| Last Update Date | 2025-06-30 |