| NPI | 1306891619 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MI 4244) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OH 5478) |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2009-02-04 |