| NPI | 1164526604 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OH 4386) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OH 4386T292) |
| Enumeration Date | 2006-09-12 |
| Last Update Date | 2012-01-26 |