NPI | 1518315365 |
---|---|
Former Name | KAYLA LEA SCHMIDT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: AL S-D57-TA-A59) |
Additional Taxonomies | 152WL0500X Optometrist, Low Vision Rehabilitation (Licence: AL S-D57-TA-A59) |
Enumeration Date | 2016-06-01 |
Last Update Date | 2024-07-22 |