NPI | 1114351921 |
---|---|
Former Name | ALEXANDRA SCHUETTE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 152W00000X Optometrist (Licence: MO 2016005437) |
Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG002827) |
152W00000X Optometrist (Licence: FL OFC61) | |
Enumeration Date | 2013-08-28 |
Last Update Date | 2019-03-29 |