| NPI | 1386085876 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MI 4901004844) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OH 6209) |
| 152W00000X Optometrist (Licence: IN 18003868) | |
| Enumeration Date | 2013-07-11 |
| Last Update Date | 2019-10-30 |