| NPI | 1265881643 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OH OPT. 6477.) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG003218) |
| Enumeration Date | 2016-06-07 |
| Last Update Date | 2016-08-04 |