NPI | 1619383106 |
---|---|
Former Name | JESSICA S LEE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: WA OD60465096) |
Additional Taxonomies | 152W00000X Optometrist (Licence: LA 1807-741AT) |
Enumeration Date | 2014-07-07 |
Last Update Date | 2021-04-28 |