| NPI | 1699706515 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MN 3057) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: WI 3048) |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2024-10-08 |