| NPI | 1578963682 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 8473TG) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NJ 270A00656100) |
| Enumeration Date | 2014-08-26 |
| Last Update Date | 2021-08-19 |