| NPI | 1124409636 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: OH 6414) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OH 6414) |
| Enumeration Date | 2015-06-11 |
| Last Update Date | 2015-07-23 |