| NPI | 1801202395 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA 15327) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY 008212) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NY TUV008212) | |
| Enumeration Date | 2014-07-07 |
| Last Update Date | 2016-01-13 |