| NPI | 1821168394 |
|---|---|
| Former Name | DEBORAH ROSE WAGNER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AZ OPT-002069) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IL 046008156) |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2022-10-26 |