| NPI | 1578184040 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 100096T) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CA OPT34555TLG) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-05-06 |
| Last Update Date | 2020-08-17 |