| NPI | 1801993555 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NM 668) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MN 2992) |
| Enumeration Date | 2006-09-17 |
| Last Update Date | 2022-01-27 |