| NPI | 1942652912 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AZ 2174) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TX 8890T) |
| Enumeration Date | 2016-07-01 |
| Last Update Date | 2021-01-07 |