| NPI | 1356962179 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 152W00000X Optometrist (Licence: OR AT4608)  | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program | 
| 152W00000X Optometrist (Licence: CO OPT.0003605)  | |
| Enumeration Date | 2020-05-04 | 
| Last Update Date | 2024-04-30 |