| NPI | 1528080710 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: GA 003225) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OH 5621) |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2023-01-20 |