NPI | 1851975718 |
---|---|
Former Name | AVERY JACQUELINE HUBER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: TX 10223TG) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2021-05-07 |
Last Update Date | 2022-08-25 |