| NPI | 1659990653 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TN 3669) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OH OPT.006887) |
| Enumeration Date | 2020-04-10 |
| Last Update Date | 2021-09-20 |