| NPI | 1144452459 |
|---|---|
| Former Name | DIANA MARIE KOESEL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OH 5534) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NC 1979) |
| Enumeration Date | 2009-08-20 |
| Last Update Date | 2009-08-20 |