| NPI | 1699532069 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 152W00000X Optometrist (Licence: OR ATI4728) | 
| Additional Taxonomies | 152WC0802X Optometrist, Corneal and Contact Management (Licence: OR ATI4728) | 
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2024-03-04 | 
| Last Update Date | 2024-06-17 |