| NPI | 1437715091 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MI 4901005728) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OH OPT.006782) |
| Enumeration Date | 2019-05-19 |
| Last Update Date | 2024-09-16 |