| NPI | 1356073860 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: SC 2419) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: OR 0000000) |
| Enumeration Date | 2022-06-24 |
| Last Update Date | 2023-08-20 |