NPI | 1861844524 |
---|---|
Former Name | CELINA ANN DIEGO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC 5311) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2016-07-06 |
Last Update Date | 2021-01-06 |