| NPI | 1164837373 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MN 3388) |
| Additional Taxonomies | 152WC0802X Optometrist Corneal and Contact Management (Licence: MN 3388) |
| 152WP0200X Optometrist Pediatrics (Licence: MN 3388) | |
| 152WS0006X Optometrist Sports Vision (Licence: MN 3388) | |
| 152WX0102X Optometrist Occupational Vision (Licence: MN 3388) | |
| Enumeration Date | 2014-06-25 |
| Last Update Date | 2020-06-16 |