NPI | 1568873123 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: MN 3411) |
Additional Taxonomies | 152W00000X Optometrist (Licence: CA 14887) |
Enumeration Date | 2014-05-16 |
Last Update Date | 2014-10-02 |