| 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 |