| NPI | 1891059374 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA 35393) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MN 3301) |
| Enumeration Date | 2012-06-28 |
| Last Update Date | 2023-03-13 |