NPI | 1538120530 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: MN 2828) |
Additional Taxonomies | 152W00000X Optometrist (Licence: IA 02246) |
Enumeration Date | 2006-03-29 |
Last Update Date | 2012-04-27 |