| NPI | 1316636699 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: PA OEG004131) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TN 3827) |
| 152W00000X Optometrist (Licence: OH OPT.007160) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2023-05-03 |
| Last Update Date | 2024-08-28 |