| NPI | 1629428511 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OH 006731) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TN 3348) |
| 152W00000X Optometrist (Licence: VA 0618002513) | |
| Enumeration Date | 2016-06-21 |
| Last Update Date | 2019-07-11 |