| NPI | 1457462285 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MI 4901003833) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MN 3105) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2013-02-18 |