| NPI | 1174244693 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 10693) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OH OPT.007047) |
| Enumeration Date | 2022-09-05 |
| Last Update Date | 2022-09-07 |