NPI | 1285126011 |
---|---|
Entity Type | Organization |
Authorized Contact | DIANE R SEREX-DOUGAN Optometrist 443-629-5459 |
Organization Subpart ? | No |
Primary Taxonomy | 152WP0200X Optometrist, Pediatrics (Licence: MD TAO849) |
Enumeration Date | 2018-06-06 |
Last Update Date | 2018-06-06 |