| NPI | 1679808752 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: ND 750) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MN 3307) |
| 152W00000X Optometrist (Licence: WI 3275-35) | |
| Enumeration Date | 2009-10-07 |
| Last Update Date | 2019-10-17 |