| NPI | 1336635242 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MN 3710) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: ND 754) |
| Enumeration Date | 2018-07-03 |
| Last Update Date | 2022-06-29 |