| NPI | 1801584792 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: GA OPT003520) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TN 3938) |
| 152W00000X Optometrist (Licence: FL 6400) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2023-04-27 |
| Last Update Date | 2023-12-10 |