| NPI | 1811736853 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WI 4012) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OH OPT.007290) |
| Enumeration Date | 2024-05-20 |
| Last Update Date | 2024-06-27 |