| NPI | 1669581765 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: ND 600) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MN 2822) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2007-07-08 |