| NPI | 1235702614 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY 009400) |
| Enumeration Date | 2021-07-22 |
| Last Update Date | 2021-07-26 |