| NPI | 1023090396 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MN 2681) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TX 07019T) |
| Enumeration Date | 2005-11-14 |
| Last Update Date | 2023-09-29 |