| NPI | 1649571035 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OH 5997) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY 007648) |
| Enumeration Date | 2010-11-16 |
| Last Update Date | 2016-10-25 |