NPI | 1790346104 |
---|---|
Other Name | LARIESA NELLIE SCHWAB |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 152W00000X Optometrist (Licence: MD TA2690) |
Additional Taxonomies | 152W00000X Optometrist (Licence: VA 0618003206) |
152W00000X Optometrist (Licence: MT OPT-OPT-LIC-4605) | |
Enumeration Date | 2019-06-26 |
Last Update Date | 2024-08-07 |