| NPI | 1578850038 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IA 002533) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MN 3230) |
| 152WP0200X Optometrist, Pediatrics (Licence: IA 002533) | |
| Enumeration Date | 2011-07-06 |
| Last Update Date | 2018-11-12 |