| NPI | 1851089296 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MN 3936) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: WI 3921) |
| 152W00000X Optometrist (Licence: IA 120548) | |
| Enumeration Date | 2023-04-25 |
| Last Update Date | 2024-10-04 |