| NPI | 1639521578 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 10193TG) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY 008465) |
| Enumeration Date | 2016-07-03 |
| Last Update Date | 2024-06-27 |