NPI | 1235569807 |
---|---|
Former Name | AMANDA MARIE TAWADROS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: VA 0618002515) |
Additional Taxonomies | 152W00000X Optometrist (Licence: IN 18003825A) |
152W00000X Optometrist (Licence: WA 60398529) | |
Enumeration Date | 2013-11-19 |
Last Update Date | 2024-03-04 |