| NPI | 1760189476 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OH OPT.007324) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MI 4901005660) |
| Enumeration Date | 2023-02-13 |
| Last Update Date | 2024-08-21 |