| NPI | 1619426004 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 9557TG) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY 009327) |
| 152W00000X Optometrist (Licence: CA 33589) | |
| Enumeration Date | 2016-09-26 |
| Last Update Date | 2025-02-17 |