| NPI | 1457695397 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OH 6430) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IN 18003764A) |
| Enumeration Date | 2012-11-15 |
| Last Update Date | 2017-05-05 |