NPI | 1699000778 |
---|---|
Former Name | AMANDA MCVAY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: WA OD 60360385) |
Additional Taxonomies | 152W00000X Optometrist (Licence: CO 2911) |
Enumeration Date | 2009-10-07 |
Last Update Date | 2021-04-07 |