| NPI | 1548753122 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MN 3562) |
| Additional Taxonomies | 152WX0102X Optometrist, Occupational Vision (Licence: MN 3562) |
| Enumeration Date | 2018-06-08 |
| Last Update Date | 2024-09-03 |