| NPI | 1649197005 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY 011472) |
| Enumeration Date | 2026-07-06 |
| Last Update Date | 2026-08-13 |