NPI | 1043265267 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 152W00000X Optometrist (Licence: MN 2573) |
Additional Taxonomies | 152W00000X Optometrist (Licence: WI 2652-035) |
Enumeration Date | 2006-05-24 |
Last Update Date | 2023-03-25 |