NPI | 1548695554 |
---|---|
Other Name | LILY LOU |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: CA OPT15040TLG) |
Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG002868) |
152W00000X Optometrist (Licence: CA OPT 15070) | |
Enumeration Date | 2013-09-09 |
Last Update Date | 2014-09-17 |