| NPI | 1972855211 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MN 3491) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NV 826) |
| Enumeration Date | 2012-10-10 |
| Last Update Date | 2018-12-18 |