| NPI | 1851383384 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 4768T) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OH 5443) |
| 152W00000X Optometrist (Licence: OH T2355) | |
| Enumeration Date | 2005-08-19 |
| Last Update Date | 2007-07-08 |