| NPI | 1760171524 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OH OPT.007318) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: AL T-258-TA-C92) |
| Enumeration Date | 2023-05-05 |
| Last Update Date | 2024-09-30 |