| NPI | 1750538245 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MN 3149) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IA 2475) |
| 152W00000X Optometrist (Licence: CO 3019) | |
| Enumeration Date | 2008-08-26 |
| Last Update Date | 2024-04-15 |