| NPI | 1962546242 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL 3775) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TX 06387T) |
| Enumeration Date | 2007-02-19 |
| Last Update Date | 2024-01-09 |