| NPI | 1548825193 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AL S-E39-TA-B70) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: AL SE39TAB70) |
| Enumeration Date | 2019-05-08 |
| Last Update Date | 2024-05-31 |