| NPI | 1679143606 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 10513) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: AZ 002504) |
| Enumeration Date | 2021-06-30 |
| Last Update Date | 2022-10-06 |