| NPI | 1700469236 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: UT 12322408-9934) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 152W00000X Optometrist (Licence: TX 10237T) | |
| Enumeration Date | 2021-05-03 |
| Last Update Date | 2023-01-04 |