| NPI | 1184507121 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MO 2025020049) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MO 2025020049) |
| Enumeration Date | 2025-07-28 |
| Last Update Date | 2025-07-28 |