| NPI | 1942555974 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: ND 771) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OH 6140) |
| 152W00000X Optometrist (Licence: MN 3297) | |
| Enumeration Date | 2012-07-16 |
| Last Update Date | 2023-02-27 |