| NPI | 1083647390 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OH 43897T) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: OH 4389) |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2021-01-13 |