| NPI | 1013965409 |
|---|---|
| Former Name | GRACE LEA DEWARS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: PA OEG 001649) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: VA 0618002700) |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2021-06-18 |