| NPI | 1366963274 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: KY 2101DT) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OH 6563) |
| Enumeration Date | 2017-06-30 |
| Last Update Date | 2022-02-23 |