| NPI | 1073243630 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NC 2691) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MN 3796) |
| Enumeration Date | 2022-06-15 |
| Last Update Date | 2024-10-21 |