| NPI | 1780362772 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 11223) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG004042) |
| Enumeration Date | 2023-07-10 |
| Last Update Date | 2024-10-31 |