| NPI | 1578026738 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MN 3668) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: WI 3553) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-04-12 |
| Last Update Date | 2023-06-15 |