| NPI | 1548781677 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 9194T) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: AZ OPT-002669) |
| 152W00000X Optometrist (Licence: MN 3825) | |
| 152W00000X Optometrist (Licence: NE 1641) | |
| Enumeration Date | 2017-06-28 |
| Last Update Date | 2024-05-17 |