| NPI | 1790312064 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA 34779) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: WA 61075768) |
| 152W00000X Optometrist (Licence: OR 4522AT) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-03-25 |
| Last Update Date | 2022-12-14 |