| NPI | 1487962478 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MN 3213) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CO 2787) |
| Enumeration Date | 2010-09-23 |
| Last Update Date | 2011-11-23 |