| NPI | 1891949830 |
|---|---|
| Former Name | HEIDI MARIE WILGENBURG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA 13437) |
| Additional Taxonomies | 152WL0500X Optometrist, Low Vision Rehabilitation (Licence: CA 13437) |
| 152W00000X Optometrist (Licence: CO 2754) | |
| Enumeration Date | 2008-11-04 |
| Last Update Date | 2011-09-28 |