| NPI | 1306156484 |
|---|---|
| Former Name | MELISSA ANN GIBSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AL S-C36-TA-873) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MS 823) |
| Enumeration Date | 2010-10-07 |
| Last Update Date | 2020-02-12 |