NPI | 1609130988 |
---|---|
Former Name | JULIA MARIE UMSTEAD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: NM 683) |
Additional Taxonomies | 152W00000X Optometrist (Licence: CA 14408) |
Enumeration Date | 2012-07-01 |
Last Update Date | 2016-09-27 |