NPI | 1790152379 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 152WC0802X Optometrist Corneal and Contact Management (Licence: PA OEG003074) |
Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG003074) |
Enumeration Date | 2015-08-30 |
Last Update Date | 2016-07-12 |