NPI | 1356629463 |
---|---|
Former Name | KRISTEN M BRUMM |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: NE 1371) |
Additional Taxonomies | 152W00000X Optometrist (Licence: IA 002526) |
Enumeration Date | 2011-07-25 |
Last Update Date | 2016-06-27 |