| NPI | 1679184766 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OH OPT.007008) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: KY 2200DT) |
| Enumeration Date | 2020-08-12 |
| Last Update Date | 2021-08-31 |