NPI | 1679031900 |
---|---|
Former Name | ASYVIA POWELL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207W00000X Ophthalmology (Licence: MN 73446) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2019-03-05 |
Last Update Date | 2023-03-27 |