NPI | 1881651511 |
---|---|
Former Name | AMANDA JO SCHOFIELD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: IL 046009775) |
Additional Taxonomies | 152W00000X Optometrist (Licence: WI 3024035) |
Enumeration Date | 2006-04-27 |
Last Update Date | 2007-12-27 |