| NPI | 1750330635 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OH 3926T9) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MI 4901003141) |
| Enumeration Date | 2006-05-09 |
| Last Update Date | 2008-02-19 |