NPI | 1801316542 |
---|---|
Former Name | REGINA HELEN GAW |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: PA OEG003265) |
Additional Taxonomies | 152W00000X Optometrist (Licence: NJ 27OA00730800) |
Enumeration Date | 2017-06-23 |
Last Update Date | 2024-07-22 |