| NPI | 1912533134 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA 34533) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TX 10081) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-03-19 |
| Last Update Date | 2021-08-03 |