| NPI | 1043403967 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WI 3085-035) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MN 3081) |
| 152W00000X Optometrist (Licence: WA 00004168) | |
| Enumeration Date | 2007-08-23 |
| Last Update Date | 2014-07-29 |