NPI | 1417579194 |
---|---|
Former Name | ABIGAIL LORRAINE SMITH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 152WP0200X Optometrist, Pediatrics (Licence: MO 2021021137) |
Additional Taxonomies | 152W00000X Optometrist (Licence: MO 2021021137) |
152W00000X Optometrist (Licence: AL S-E63-TA-B74) | |
Enumeration Date | 2020-05-15 |
Last Update Date | 2022-08-09 |