| NPI | 1386927861 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CO 2939) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OH 6070) |
| Enumeration Date | 2011-09-21 |
| Last Update Date | 2013-12-04 |