| NPI | 1316397615 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WI 3610-35) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MN 3485) |
| Enumeration Date | 2016-06-16 |
| Last Update Date | 2025-09-04 |