| NPI | 1194955310 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OH 6349) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MO 2009020663) |
| 152W00000X Optometrist (Licence: IL 046.010230) | |
| Enumeration Date | 2009-07-22 |
| Last Update Date | 2022-08-05 |