| NPI | 1366548752 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: ND 493) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MN 2313) |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2007-07-08 |