| NPI | 1760867402 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CO OPT.0003152) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OH OPT.6405) |
| Enumeration Date | 2015-07-23 |
| Last Update Date | 2022-06-21 |