| NPI | 1912023714 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: ND ND597) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MN 2824) |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2007-07-08 |