| NPI | 1801969019 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 5481TG) | 
| Additional Taxonomies | 152WC0802X Optometrist, Corneal and Contact Management (Licence: TX 5481TG) | 
| 152WP0200X Optometrist, Pediatrics (Licence: TX 5481TG) | |
| 152WS0006X Optometrist, Sports Vision (Licence: TX 5481TG) | |
| 152WV0400X Optometrist, Vision Therapy (Licence: TX 5481TG) | |
| Enumeration Date | 2006-11-16 | 
| Last Update Date | 2024-06-14 |