| NPI | 1679000590 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: KY 2355DT) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OH OPT.006722) |
| 152W00000X Optometrist (Licence: MI 4901005044) | |
| Enumeration Date | 2017-05-23 |
| Last Update Date | 2023-08-10 |