| NPI | 1225654932 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NC 2616) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 152W00000X Optometrist (Licence: NC Pending) | |
| Enumeration Date | 2020-06-18 |
| Last Update Date | 2020-11-13 |