NPI | 1083972038 |
---|---|
Former Name | ANNA COLE GRUNDSTROM |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207W00000X Ophthalmology (Licence: WI 82486) |
Additional Taxonomies | 207W00000X Ophthalmology (Licence: HI MD-18752) |
Enumeration Date | 2012-04-27 |
Last Update Date | 2023-10-03 |