| NPI | 1497390173 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 152W00000X Optometrist (Licence: AZ 2410)  | 
| Additional Taxonomies | 152W00000X Optometrist (Licence: TX 9878T)  | 
| Enumeration Date | 2019-11-17 | 
| Last Update Date | 2022-06-22 |