| NPI | 1740208925 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 6926T) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CO OPT.0002901) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2022-02-10 |