| NPI | 1780022210 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MN 3548) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: WI 3308-35) |
| Enumeration Date | 2013-06-06 |
| Last Update Date | 2018-04-19 |