| NPI | 1780133058 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL 3260) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OH 4670) |
| Enumeration Date | 2016-09-28 |
| Last Update Date | 2016-09-28 |