| NPI | 1659386035 |
|---|---|
| Former Name | STEPHANIE JUDKINS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TN 2766) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CA 14122TLG) |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2016-02-01 |