| NPI | 1760623268 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 9758TG) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MD TA2133) |
| 152W00000X Optometrist (Licence: NY 56 007299) | |
| Enumeration Date | 2009-03-12 |
| Last Update Date | 2021-10-21 |