| NPI | 1902196876 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 8771) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TX 8771T) |
| Enumeration Date | 2011-04-13 |
| Last Update Date | 2022-05-11 |