| NPI | 1811518004 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OK 3100) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: AZ OPT-002492) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-04-29 |
| Last Update Date | 2022-12-01 |