| NPI | 1780796490 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OH OPT006514) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG003132) |
| 152W00000X Optometrist (Licence: PA OET009007) | |
| 152WX0102X Optometrist, Occupational Vision (Licence: OH OPT006514) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2021-07-09 |