| NPI | 1477617058 |
|---|---|
| Former Name | LESLIE LOVE GRAHAM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 9744T) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: AL S 828 TA 356) |
| Enumeration Date | 2006-12-20 |
| Last Update Date | 2022-09-12 |