| NPI | 1255580189 |
|---|---|
| Former Name | LESLIE DIANNE WORTHINGTON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NC 2137) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: VA 0618001800) |
| Enumeration Date | 2008-09-16 |
| Last Update Date | 2018-03-17 |