| NPI | 1124307871 |
|---|---|
| Former Name | TERESA C SHIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OR 3588AT) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CA 14270) |
| 152W00000X Optometrist (Licence: WA OD60636151) | |
| Enumeration Date | 2011-08-12 |
| Last Update Date | 2016-05-12 |