| NPI | 1225261266 |
|---|---|
| Former Name | MARY KORMANAK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MA 4772) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG002201) |
| Enumeration Date | 2009-08-25 |
| Last Update Date | 2019-07-09 |