| NPI | 1790349074 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 10753T) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: FL OPC5647) |
| Enumeration Date | 2019-04-23 |
| Last Update Date | 2023-02-13 |