NPI | 1710017975 |
---|---|
Former Name | ERIN MAXIMIEK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 152W00000X Optometrist (Licence: NC 2441) |
Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG001819) |
Enumeration Date | 2007-03-06 |
Last Update Date | 2020-10-26 |