NPI | 1003879727 |
---|---|
Former Name | KRISTEN LYNN JALOSZYNSKI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: IA 2314) |
Additional Taxonomies | 152WL0500X Optometrist, Low Vision Rehabilitation (Licence: IA 2314) |
Enumeration Date | 2006-04-11 |
Last Update Date | 2012-01-27 |