| NPI | 1619951035 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NC 1354) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OH 3886) |
| Enumeration Date | 2005-11-30 |
| Last Update Date | 2011-05-04 |