| NPI | 1902349137 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OH OPT006548) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MI 4901004979) |
| Enumeration Date | 2016-11-20 |
| Last Update Date | 2022-07-21 |