NPI | 1689971673 |
---|---|
Former Name | CHRISTINA BLANDON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 156FX1202X Technician/Technologist, Optometric Technician |
Additional Taxonomies | 156FX1800X Technician/Technologist, Optician (Licence: MO 170167) |
Enumeration Date | 2011-02-28 |
Last Update Date | 2015-10-13 |