| NPI | 1063190247 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MN 3913) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TN 3825) |
| Enumeration Date | 2023-07-07 |
| Last Update Date | 2024-08-14 |