| NPI | 1518194372 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MN 3350) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY TUV007457-1) |
| Enumeration Date | 2009-06-18 |
| Last Update Date | 2021-03-11 |