| NPI | 1659706802 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OH OPT.6435-THER) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: RI ODTG00598) |
| Enumeration Date | 2013-09-06 |
| Last Update Date | 2016-05-10 |