| NPI | 1982604591 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: SD T482) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MN 3044) |
| 152W00000X Optometrist (Licence: CA OPT6680) | |
| Enumeration Date | 2005-07-26 |
| Last Update Date | 2023-03-22 |