| NPI | 1396129904 |
|---|---|
| Former Name | TAIA CORDEL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MO 2015019553) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: KS 2000) |
| Enumeration Date | 2015-07-13 |
| Last Update Date | 2018-05-02 |