NPI | 1306030408 |
---|---|
Former Name | KRISTY CHMILEWSKI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: VA 0618001729) |
Additional Taxonomies | 152W00000X Optometrist (Licence: OH 5708) |
Enumeration Date | 2007-08-31 |
Last Update Date | 2020-09-11 |