| NPI | 1962246041 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA 35894) |
| Additional Taxonomies | 152WP0200X Optometrist, Pediatrics (Licence: CA 35894) |
| 152W00000X Optometrist (Licence: TX 11106T) | |
| 152WP0200X Optometrist, Pediatrics (Licence: TX 11106T) | |
| Enumeration Date | 2024-06-24 |
| Last Update Date | 2026-01-18 |