| NPI | 1588929863 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MN 3492) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OH 6151) |
| Enumeration Date | 2012-07-11 |
| Last Update Date | 2025-05-29 |