| NPI | 1962071829 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 10291) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TX 10291TG) |
| Enumeration Date | 2021-06-23 |
| Last Update Date | 2022-05-12 |