NPI | 1306376116 |
---|---|
Former Name | JEANNETTE MARIE ADELSBERGER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: MA OPT5270) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2017-06-14 |
Last Update Date | 2024-04-03 |