| NPI | 1639341498 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 6971TG)  | 
| Additional Taxonomies | 152WV0400X Optometrist, Vision Therapy (Licence: TX 6971TG)  | 
| Enumeration Date | 2008-04-01 | 
| Last Update Date | 2024-09-12 |