NPI | 1144400599 |
---|---|
Former Name | MONICA GAMMILL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 152W00000X Optometrist (Licence: AZ 1604) |
Additional Taxonomies | 152W00000X Optometrist (Licence: OR 3214ATI) |
Enumeration Date | 2007-11-13 |
Last Update Date | 2024-05-05 |