| NPI | 1174009948 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA 34152) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CA TBD) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-07-16 |
| Last Update Date | 2022-02-01 |