| NPI | 1255013850 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OH 007195) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: KY 2348DT) |
| Enumeration Date | 2023-08-02 |
| Last Update Date | 2023-08-02 |