NPI | 1770749483 |
---|---|
Former Name | ALESHA SMITH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: VA 0618001770) |
Additional Taxonomies | 152W00000X Optometrist (Licence: NJ 27OA00672200) |
152W00000X Optometrist (Licence: MD TA2109) | |
Enumeration Date | 2008-08-01 |
Last Update Date | 2021-08-11 |