NPI | 1053099796 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: MN 3885) |
Additional Taxonomies | 152W00000X Optometrist (Licence: TX 10809T) |
Enumeration Date | 2023-07-11 |
Last Update Date | 2024-10-07 |