| NPI | 1396059895 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MN 3221) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IL 046010402) |
| Enumeration Date | 2010-07-27 |
| Last Update Date | 2012-03-21 |