| NPI | 1821735218 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IL 046011655) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IL 046.011655) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2022-05-17 |
| Last Update Date | 2024-03-21 |