| NPI | 1578729273 |
|---|---|
| Former Name | KELLY TRUONG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA 13690) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IL 046010070) |
| Enumeration Date | 2008-08-01 |
| Last Update Date | 2018-06-11 |