| NPI | 1902889637 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CO 2529) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OH 5473) |
| Enumeration Date | 2005-11-28 |
| Last Update Date | 2009-05-21 |