| NPI | 1528143781 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MN 2467) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: FL 3001) |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2022-06-23 |