| NPI | 1922594647 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA 34411) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OH 006630) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-07-05 |
| Last Update Date | 2024-07-19 |