| NPI | 1730668062 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: KY 2357DT) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MN 3584) |
| Enumeration Date | 2018-08-08 |
| Last Update Date | 2024-07-30 |