NPI | 1861748329 |
---|---|
Former Name | ELIZABETH ANN RONAU |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: SC 1918) |
Additional Taxonomies | 152W00000X Optometrist (Licence: KY 1892DT) |
Enumeration Date | 2012-08-01 |
Last Update Date | 2022-03-10 |