| NPI | 1114301645 |
|---|---|
| Former Name | JESSICA ANN TAYLOR |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TN 3258) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MS 926) |
| Enumeration Date | 2015-07-14 |
| Last Update Date | 2017-03-29 |