NPI | 1770932147 |
---|---|
Former Name | ASHLEY VERDON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: NY 008423) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2016-06-07 |
Last Update Date | 2019-04-17 |