| NPI | 1992475768 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 10495) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG003815) |
| Enumeration Date | 2021-09-14 |
| Last Update Date | 2022-04-01 |