| NPI | 1407046022 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MN 3083) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: WI 3868-35) |
| Enumeration Date | 2007-07-30 |
| Last Update Date | 2023-03-02 |