NPI | 1902368939 |
---|---|
Former Name | NICOLE DAWN CHARRY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: OH OPT.006810) |
Additional Taxonomies | 152W00000X Optometrist (Licence: OK 2968) |
Enumeration Date | 2019-03-31 |
Last Update Date | 2024-02-06 |