| NPI | 1104017409 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CO 2999) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OH 5721) |
| 152W00000X Optometrist (Licence: OH T2635) | |
| Enumeration Date | 2007-08-05 |
| Last Update Date | 2013-10-29 |