| NPI | 1942378468 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MN 2577) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: VA 0618001376) |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2011-11-22 |