| NPI | 1467712133 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OH 6165) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MN 3406) |
| Enumeration Date | 2012-05-29 |
| Last Update Date | 2021-05-12 |