| NPI | 1487439568 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MN 3919) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MI 4901005730) |
| Enumeration Date | 2023-08-28 |
| Last Update Date | 2024-08-22 |