NPI | 1356687412 |
---|---|
Former Name | ELIZABETH MARIE NAVITSKY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: MO 2012028150) |
Additional Taxonomies | 152W00000X Optometrist (Licence: IL 046010641) |
Enumeration Date | 2012-12-18 |
Last Update Date | 2022-08-29 |