NPI | 1588117378 |
---|---|
Former Name | CHRISTINE GRANT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: MA 5154) |
Additional Taxonomies | 152W00000X Optometrist (Licence: NH 0933) |
Enumeration Date | 2016-07-27 |
Last Update Date | 2017-02-24 |