| NPI | 1255993077 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: ND ND774) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MN 3637) |
| Enumeration Date | 2019-07-01 |
| Last Update Date | 2022-07-07 |