| NPI | 1558925248 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: GA OPT003235) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OH 006754) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-04-28 |
| Last Update Date | 2020-07-09 |