| NPI | 1306339734 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OH OPT.006803) |
| Additional Taxonomies | 152WP0200X Optometrist, Pediatrics (Licence: VA 0618002652) |
| Enumeration Date | 2018-06-11 |
| Last Update Date | 2019-07-16 |