| NPI | 1477688752 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 5392TG) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OE008115P) |
| Enumeration Date | 2007-02-23 |
| Last Update Date | 2022-07-21 |