| NPI | 1649624990 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OH OPT.6469) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OH 6469) |
| Enumeration Date | 2016-04-22 |
| Last Update Date | 2019-01-28 |