| NPI | 1861052573 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OR 4557) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TX 9808) |
| 152W00000X Optometrist (Licence: WA OD61393933) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-06-14 |
| Last Update Date | 2025-05-12 |