| NPI | 1932630902 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: HI OD-838) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CA ANTICIPATED 06/2017) |
| Enumeration Date | 2017-03-22 |
| Last Update Date | 2019-01-03 |