| NPI | 1710660964 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 11142T) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: GA OPT003528) |
| Enumeration Date | 2023-08-14 |
| Last Update Date | 2024-09-26 |