| NPI | 1265923247 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CO OPT-000395) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 152W00000X Optometrist (Licence: CT 3.003229) | |
| Enumeration Date | 2018-05-24 |
| Last Update Date | 2022-02-07 |