NPI | 1386780187 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: MN 0422) |
Additional Taxonomies | 152W00000X Optometrist (Licence: ND 491) |
Enumeration Date | 2007-01-29 |
Last Update Date | 2007-07-08 |