| NPI | 1750544383 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MN 3141) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: WI 3110-35) |
| Enumeration Date | 2008-07-03 |
| Last Update Date | 2017-05-12 |