| NPI | 1740718626 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MN 3661) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IN NA) |
| Enumeration Date | 2017-05-23 |
| Last Update Date | 2020-08-17 |