| NPI | 1750554002 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CO 2249) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OH 5481) |
| Enumeration Date | 2008-04-08 |
| Last Update Date | 2022-07-21 |