| NPI | 1992173470 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MN 3813) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IL 046010964) |
| Enumeration Date | 2015-09-14 |
| Last Update Date | 2022-09-28 |