| NPI | 1821782913 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MN 3921) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: RI ODTA00573) |
| Enumeration Date | 2023-06-05 |
| Last Update Date | 2024-07-05 |