| NPI | 1669885422 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MN 3379) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: ND 840) |
| Enumeration Date | 2014-06-09 |
| Last Update Date | 2026-03-25 |