| NPI | 1104388800 |
|---|---|
| Former Name | TESIA WYSZOMIRSKI |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IL 046-011470) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: AZ OPT-002688) |
| 152W00000X Optometrist (Licence: MT OPT-OPT-LIC-3977) | |
| 152W00000X Optometrist (Licence: PA OEG004021) | |
| 152W00000X Optometrist (Licence: WI 3890-35) | |
| 152W00000X Optometrist (Licence: FL TPOP67) | |
| Enumeration Date | 2019-04-02 |
| Last Update Date | 2023-06-27 |