NPI | 1205039674 |
---|---|
Former Name | ANDREA NICOLE CAMP |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: NY 007042) |
Additional Taxonomies | 152W00000X Optometrist (Licence: NY TUV007042) |
Enumeration Date | 2007-06-06 |
Last Update Date | 2016-08-28 |