| NPI | 1427408798 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: SD 735) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MN 3487) |
| Enumeration Date | 2016-06-17 |
| Last Update Date | 2017-04-10 |