NPI | 1336707082 |
---|---|
Former Name | LESLIE SOMOHANO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC005989) |
Additional Taxonomies | 152W00000X Optometrist (Licence: MA 1689870602) |
Enumeration Date | 2019-05-29 |
Last Update Date | 2022-04-27 |