| NPI | 1043837925 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OH OPT.006864) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MI 4901005450) |
| Enumeration Date | 2020-06-26 |
| Last Update Date | 2021-08-12 |