| NPI | 1174974380 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MA 5255) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OH 6440) |
| 152WC0802X Optometrist, Corneal and Contact Management (Licence: OH 6440) | |
| Enumeration Date | 2016-06-29 |
| Last Update Date | 2022-07-21 |