| NPI | 1487719274 |
|---|---|
| Former Name | LADAN CHARLENE MOHTADI |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 8377T) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CA 12618T) |
| Enumeration Date | 2006-12-22 |
| Last Update Date | 2023-04-14 |