NPI | 1467782383 |
---|---|
Former Name | CHANDA LEE HJELMGREN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 152W00000X Optometrist (Licence: VA 0618001402) |
Additional Taxonomies | 152W00000X Optometrist (Licence: FL OPC 3803) |
152W00000X Optometrist (Licence: DC OP1000090) | |
Enumeration Date | 2009-12-29 |
Last Update Date | 2014-09-30 |