| NPI | 1528090420 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MN 2605) |
| Additional Taxonomies | 152WV0400X Optometrist, Vision Therapy (Licence: MN 2605) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2020-10-14 |