| NPI | 1629508429 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IL 046.011103) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OH OPT6567) |
| Enumeration Date | 2017-06-14 |
| Last Update Date | 2017-08-22 |