| NPI | 1972564185 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OH 3780) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OH T350) |
| Enumeration Date | 2006-03-29 |
| Last Update Date | 2007-07-08 |