| NPI | 1073616355 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: KY 1798DT) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: WV 986-od) |
| 152W00000X Optometrist (Licence: OH 5366 T2277) | |
| Enumeration Date | 2006-09-05 |
| Last Update Date | 2012-08-30 |