| NPI | 1982265849 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 10148T) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY 009126) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-06-21 |
| Last Update Date | 2021-03-31 |