| NPI | 1568449353 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CO 2638) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TX 6449TG) |
| Enumeration Date | 2005-12-22 |
| Last Update Date | 2022-08-04 |