| NPI | 1073196093 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: GA OPT003483) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: AL S-E86) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-04-29 |
| Last Update Date | 2023-01-08 |