NPI | 1700084456 |
---|---|
Former Name | CAROL SHIM |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 152W00000X Optometrist (Licence: WA OD60188672) |
Additional Taxonomies | 152W00000X Optometrist (Licence: CA 13281) |
Enumeration Date | 2007-07-04 |
Last Update Date | 2019-09-26 |