| NPI | 1104493717 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NY TUV009405) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY 009405) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-06-10 |
| Last Update Date | 2021-09-24 |