| NPI | 1508536343 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA 35032) |
| Additional Taxonomies | 261QS1000X Clinic/Center, Student Health |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-09-14 |
| Last Update Date | 2023-12-22 |