| NPI | 1477275436 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WI 3866-35) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: WI 0000000000) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2022-09-16 |
| Last Update Date | 2023-01-22 |