| NPI | 1588282495 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 09937) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX 09937) |
| Enumeration Date | 2020-07-07 |
| Last Update Date | 2020-10-08 |