NPI | 1083053318 |
---|---|
Former Name | ERICA LYNNE STUBBS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 152W00000X Optometrist (Licence: GA OPT003133) |
Additional Taxonomies | 152W00000X Optometrist (Licence: NY TUV008007-1) |
Enumeration Date | 2013-06-20 |
Last Update Date | 2019-05-15 |