| NPI | 1194248641 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152WP0200X Optometrist Pediatrics (Licence: KY 2103DT) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OH 6581) |
| Enumeration Date | 2017-07-17 |
| Last Update Date | 2021-11-16 |