| NPI | 1922188960 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AL R-238-TA-A10) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OH 4730) |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2016-09-08 |