| NPI | 1598331274 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OH OPT.007003) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: KY 2252DT) |
| Enumeration Date | 2021-06-02 |
| Last Update Date | 2023-01-27 |