| NPI | 1376772319 |
|---|---|
| Former Name | BRANDI LEA YOUNG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: VA 0618001844) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MD TA2170) |
| Enumeration Date | 2009-07-13 |
| Last Update Date | 2018-06-25 |