| NPI | 1396489308 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NC 2792) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OH OPT.007058) |
| Enumeration Date | 2022-04-25 |
| Last Update Date | 2024-03-27 |