| NPI | 1053035162 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: ND 800) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MN 3828) |
| Enumeration Date | 2022-10-03 |
| Last Update Date | 2022-10-14 |