| NPI | 1255733309 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MN 2002) |
| Additional Taxonomies | 152WV0400X Optometrist, Vision Therapy (Licence: MN 2002) |
| Enumeration Date | 2014-09-19 |
| Last Update Date | 2019-02-27 |