| NPI | 1396115606 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OH 006708) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: VA 0618002401) |
| Enumeration Date | 2015-09-29 |
| Last Update Date | 2024-10-20 |