NPI | 1003220880 |
---|---|
Former Name | ABBY BRUBAKER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: PA OEG002936) |
Additional Taxonomies | 152W00000X Optometrist (Licence: MA 5083) |
Enumeration Date | 2014-06-19 |
Last Update Date | 2024-05-31 |