NPI | 1922043496 |
---|---|
Former Name | JENNIFER KAREN MARSHALL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 152W00000X Optometrist (Licence: GA OPT 002111) |
Additional Taxonomies | 152W00000X Optometrist (Licence: FL OPC 4030) |
Enumeration Date | 2006-06-18 |
Last Update Date | 2024-06-13 |