| NPI | 1700998671 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MA 3692) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OH 4532 T1262) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2007-07-08 |