| NPI | 1639803497 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 10613TG)  | 
| Additional Taxonomies | 152W00000X Optometrist (Licence: TX 10613)  | 
| Enumeration Date | 2022-07-15 | 
| Last Update Date | 2023-04-10 |