| NPI | 1699839845 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OH 4885) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: VA 0618001173) |
| Enumeration Date | 2006-12-21 |
| Last Update Date | 2012-08-31 |