| NPI | 1033130554 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA 13052) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: WI 3092-035) |
| 152W00000X Optometrist (Licence: MN 3072) | |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2010-07-30 |