| NPI | 1114181526 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OH 5785) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: KY 1736DT) |
| Enumeration Date | 2008-07-15 |
| Last Update Date | 2014-01-08 |