| NPI | 1538335369 |
|---|---|
| Former Name | MARY ALLISON ROENSCH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: GA 66312) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: TX BP10031491) |
| 207W00000X Ophthalmology (Licence: GA 066312) | |
| Enumeration Date | 2008-05-01 |
| Last Update Date | 2016-11-03 |