| NPI | 1003263559 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AL S-D63-TA-A44) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: AL S-D63) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-05-14 |
| Last Update Date | 2016-08-10 |