| NPI | 1780051763 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 10506) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: VI VI61) |
| Enumeration Date | 2015-08-26 |
| Last Update Date | 2023-10-06 |