NPI | 1093024176 |
---|---|
Former Name | CHRISTINE WAHLSTEDT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: ID ODP-100272) |
Additional Taxonomies | 152W00000X Optometrist (Licence: WA OD60369639) |
Enumeration Date | 2010-10-06 |
Last Update Date | 2022-09-03 |