| NPI | 1982625679 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OK 2393) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TX 6444T) |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2022-06-13 |