NPI | 1871889428 |
---|---|
Former Name | LAURA ANN VICKERS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207W00000X Ophthalmology (Licence: MA 278507) |
Additional Taxonomies | 207W00000X Ophthalmology (Licence: NC 201401268) |
207W00000X Ophthalmology (Licence: NH 24941) | |
Enumeration Date | 2011-06-22 |
Last Update Date | 2023-12-13 |