| NPI | 1821478371 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MN 3894) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: ME OPT994) |
| Enumeration Date | 2015-05-30 |
| Last Update Date | 2025-01-15 |