| NPI | 1952454662 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OH 4002) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA oe006855p) |
| 152W00000X Optometrist (Licence: CO 1393) | |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2007-07-08 |