| NPI | 1386958452 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MN 3232) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: WI 3973) |
| Enumeration Date | 2010-08-02 |
| Last Update Date | 2025-02-05 |