NPI | 1851310817 |
---|---|
Former Name | REGINA KATHLEEN COLEMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: KY KY1313DT) |
Additional Taxonomies | 152W00000X Optometrist (Licence: KY 1313DT) |
Enumeration Date | 2006-07-19 |
Last Update Date | 2021-01-22 |