NPI | 1215460969 |
---|---|
Former Name | CHRISTINE M CRAIG |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: VA 0618002570) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2017-04-10 |
Last Update Date | 2019-01-21 |