| NPI | 1912038175 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OH 3813 T561) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: KY 1067DT) |
| 152W00000X Optometrist (Licence: VA 0601001285) | |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2007-07-08 |