NPI | 1184696619 |
---|---|
Former Name | KARI L SPRAGUE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: KS 1713) |
Additional Taxonomies | 152W00000X Optometrist (Licence: MO 2005020535) |
Enumeration Date | 2006-02-07 |
Last Update Date | 2010-11-08 |