| NPI | 1194117333 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IL 046010936) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OH 6284) |
| 152W00000X Optometrist (Licence: MI L434997) | |
| Enumeration Date | 2015-02-25 |
| Last Update Date | 2016-11-16 |