| NPI | 1790821791 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OH OH5375) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: KY 1602DT) |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2007-07-09 |