| NPI | 1699555995 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NY 009914) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TX 10847) |
| Enumeration Date | 2023-10-03 |
| Last Update Date | 2023-11-28 |