| NPI | 1619406154 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MA 5239) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NH 0977) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-06-08 |
| Last Update Date | 2022-06-15 |