| NPI | 1124682752 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY 008982) |
| Enumeration Date | 2019-04-29 |
| Last Update Date | 2019-10-16 |