NPI | 1073706578 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: MI 4901004430) |
Additional Taxonomies | 152W00000X Optometrist (Licence: OH 5725) |
Enumeration Date | 2007-08-20 |
Last Update Date | 2012-09-26 |