NPI | 1104144609 |
---|---|
Former Name | JULIE LAUREN KIESSLING |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207WX0110X Ophthalmology, Pediatric Ophthalmology and Strabismus Specialist (Licence: AL 34000) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2010-05-07 |
Last Update Date | 2023-10-02 |