| NPI | 1063460509 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OH OPT 5498) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OH T 2410) |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2009-11-12 |