| NPI | 1558701268 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WI 3499-35) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OH 6232-T3147) |
| Enumeration Date | 2013-06-26 |
| Last Update Date | 2022-06-03 |