| NPI | 1194735118 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WI 3288-35) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MN 3048) |
| 152W00000X Optometrist (Licence: IA 083641) | |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2017-04-20 |