| NPI | 1053795922 |
|---|---|
| Former Name | AMANDA GERROUGE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NY TUV008412) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG003061) |
| Enumeration Date | 2015-07-10 |
| Last Update Date | 2018-11-29 |