| NPI | 1669707741 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WA OD60431512) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MN 3318) |
| 152W00000X Optometrist (Licence: OR 3398-ATI) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2009-10-07 |
| Last Update Date | 2022-02-04 |