| NPI | 1568235489 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MN 3993) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: ND 815) |
| Enumeration Date | 2023-11-02 |
| Last Update Date | 2025-05-13 |