| NPI | 1861073942 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MI 4901005634) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: TN 3684) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-04-19 |
| Last Update Date | 2022-09-09 |