| NPI | 1235640368 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CO 0003383) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OH 006605) |
| Enumeration Date | 2017-10-16 |
| Last Update Date | 2018-10-12 |