| NPI | 1528418605 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 8964T) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: FL OPC005342) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-06-20 |
| Last Update Date | 2023-08-16 |