| NPI | 1629323241 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MN 3541) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG002666) |
| Enumeration Date | 2012-07-19 |
| Last Update Date | 2026-09-03 |