| NPI | 1689677064 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 6073) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TX 6073TG) |
| Enumeration Date | 2005-05-31 |
| Last Update Date | 2022-05-11 |