NPI | 1205911435 |
---|---|
Former Name | MOLLY ELIZABETH DULA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: PA OEG000485) |
Additional Taxonomies | 152W00000X Optometrist (Licence: WV 1012OD) |
Enumeration Date | 2006-10-26 |
Last Update Date | 2021-12-20 |