| NPI | 1356199202 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MI 5315264364) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OH OPT.007261) |
| Enumeration Date | 2024-05-07 |
| Last Update Date | 2026-06-17 |