NPI | 1710936885 |
---|---|
Former Name | KRISTIE FECHT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: IL 046009735) |
Additional Taxonomies | 152W00000X Optometrist (Licence: MO T03471) |
Enumeration Date | 2006-05-08 |
Last Update Date | 2023-12-05 |