NPI | 1164787628 |
---|---|
Former Name | SELENA CONSTANCE CHU |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: CA 33549) |
Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG002662) |
Enumeration Date | 2012-07-11 |
Last Update Date | 2024-06-12 |