| NPI | 1992014567 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 7542TG) |
| Additional Taxonomies | 152WS0006X Optometrist, Sports Vision (Licence: TX 7542TG) |
| Enumeration Date | 2010-09-30 |
| Last Update Date | 2023-02-20 |