| NPI | 1013171743 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IN 18003549) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OH 5808) |
| Enumeration Date | 2008-07-11 |
| Last Update Date | 2011-06-28 |