NPI | 1629074612 |
---|---|
Former Name | ANGELA M EDWARDS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 152W00000X Optometrist (Licence: TX 8576TG) |
Additional Taxonomies | 152W00000X Optometrist (Licence: OK 2386) |
Enumeration Date | 2005-06-23 |
Last Update Date | 2015-04-29 |