| NPI | 1972881993 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 8662TG) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: LA 1630-663t) |
| Enumeration Date | 2011-07-25 |
| Last Update Date | 2021-11-02 |