| NPI | 1609509884 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA 35220) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NV 1149) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2022-07-06 |
| Last Update Date | 2023-03-10 |