NPI | 1780995282 |
---|---|
Former Name | KRISTIN SKREDENSKE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: MO 2010020771) |
Additional Taxonomies | 152W00000X Optometrist (Licence: IL 046.010434) |
Enumeration Date | 2010-06-29 |
Last Update Date | 2018-10-03 |