| NPI | 1063728277 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: VA 0618002793) |
| Additional Taxonomies | 156F00000X Technician/Technologist |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-08-25 |
| Last Update Date | 2023-05-16 |