NPI | 1730434390 |
---|---|
Former Name | ALEXANDRA TROY |
Entity Type | Individual |
Gender | N/A |
Sole Proprietor ? | Yes |
Primary Taxonomy | 152WL0500X Optometrist, Low Vision Rehabilitation (Licence: MI 4901004798) |
Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG002667) |
152WL0500X Optometrist, Low Vision Rehabilitation (Licence: IL 046010680) | |
Enumeration Date | 2012-07-19 |
Last Update Date | 2020-07-17 |