| NPI | 1023169638 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OH 4813-T1678) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MI 4901004088) |
| 152W00000X Optometrist (Licence: CT 002713) | |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2016-02-10 |