| NPI | 1679311690 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152WP0200X Optometrist, Pediatrics (Licence: OH OPT.007401) |
| Additional Taxonomies | 152WP0200X Optometrist, Pediatrics (Licence: WI 4034-35) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2024-07-15 |
| Last Update Date | 2025-08-07 |