NPI | 1609833870 |
---|---|
Former Name | ANGELA B ABRAHAM |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: MA 4848) |
Additional Taxonomies | 152W00000X Optometrist (Licence: SC SC1069) |
Enumeration Date | 2006-04-29 |
Last Update Date | 2023-07-14 |