| NPI | 1366404386 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MN 1959) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: WI 1961-035) |
| Enumeration Date | 2006-04-05 |
| Last Update Date | 2011-10-19 |