| NPI | 1639869662 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: VA 0618003253) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TX 10950) |
| Enumeration Date | 2023-05-12 |
| Last Update Date | 2023-10-30 |