| NPI | 1922670876 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NC 2710) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MN 3758) |
| Enumeration Date | 2021-07-12 |
| Last Update Date | 2022-11-09 |