| NPI | 1427602051 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: SC OPT2228) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IL 046.011343) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: IL 046.011343) | |
| Enumeration Date | 2019-07-31 |
| Last Update Date | 2022-03-07 |