NPI | 1285610741 |
---|---|
Former Name | CAROL L IRELAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: IN 18003343) |
Additional Taxonomies | 152W00000X Optometrist (Licence: KY 1778DT) |
Enumeration Date | 2005-12-16 |
Last Update Date | 2011-10-25 |