NPI | 1043707201 |
---|---|
Former Name | KATHERINE NELSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: TX 10837) |
Additional Taxonomies | 152W00000X Optometrist (Licence: IL 046011185) |
Enumeration Date | 2018-04-13 |
Last Update Date | 2023-06-30 |