NPI | 1457370405 |
---|---|
Former Name | MICHELLE BEACHKOFSKY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: NC 2436) |
Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG001700) |
Enumeration Date | 2006-07-19 |
Last Update Date | 2023-10-04 |