| NPI | 1346285210 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MI 4901004281) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OH 5381) |
| 152WP0200X Optometrist Pediatrics (Licence: OH 5381 T2292) | |
| Enumeration Date | 2006-06-17 |
| Last Update Date | 2010-08-19 |