NPI | 1467826768 |
---|---|
Former Name | JULIA SIMON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: MT 3964) |
Additional Taxonomies | 152W00000X Optometrist (Licence: NJ 27oa00661800) |
Enumeration Date | 2015-11-24 |
Last Update Date | 2022-11-10 |