| NPI | 1356030993 |
|---|---|
| Former Name | MARY ELIZABETH HOLDER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: KY 2349DT) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2023-05-01 |
| Last Update Date | 2025-01-16 |