NPI | 1548310212 |
---|---|
Professional Name | SUSAN FONG BOARMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: CO OPT.0002518) |
Additional Taxonomies | 152W00000X Optometrist (Licence: VA 0618001026) |
152W00000X Optometrist (Licence: MD TA1598) | |
Enumeration Date | 2007-01-12 |
Last Update Date | 2023-10-30 |