| NPI | 1952923526 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 10534) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MA 5489) |
| 152W00000X Optometrist (Licence: CA 34602) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-05-17 |
| Last Update Date | 2022-07-13 |