NPI | 1043207236 |
---|---|
Former Name | WENDY HOWERTON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: KS 1560) |
Additional Taxonomies | 152W00000X Optometrist (Licence: MO T03465) |
Enumeration Date | 2005-10-03 |
Last Update Date | 2011-12-06 |