| NPI | 1134486269 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MI 4901004680) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OH OPT.6008-THER) |
| Enumeration Date | 2012-04-13 |
| Last Update Date | 2025-11-03 |