| 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 |