| NPI | 1811635329 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OH OPT.007035) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: KY 2295DT) |
| Enumeration Date | 2022-05-24 |
| Last Update Date | 2022-11-17 |