NPI | 1881002855 |
---|---|
Former Name | VICTORIA ROSE PRICHODKO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: MO 2014025418) |
Additional Taxonomies | 152WP0200X Optometrist, Pediatrics (Licence: MO 2014025418) |
Enumeration Date | 2014-07-23 |
Last Update Date | 2014-11-03 |