| NPI | 1902809338 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 6659)  | 
| Additional Taxonomies | 152W00000X Optometrist (Licence: TX 6659T)  | 
| Enumeration Date | 2005-05-31 | 
| Last Update Date | 2022-05-12 |