NPI | 1871013250 |
---|---|
Former Name | KIMBERLY HARMON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: IN 18004058A) |
Additional Taxonomies | 152W00000X Optometrist (Licence: IL 046011129) |
Enumeration Date | 2017-06-26 |
Last Update Date | 2023-10-17 |