| NPI | 1912572397 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IL 046011512) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MA 5557) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-05-26 |
| Last Update Date | 2024-06-21 |