| NPI | 1962852350 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 9725T) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: KS KS 2028) |
| Enumeration Date | 2016-06-15 |
| Last Update Date | 2020-01-25 |