| NPI | 1083657639 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NC 2021) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OH 5580) |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2024-01-04 |