NPI | 1922314137 |
---|---|
Former Name | LAURA E GENGELBACH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 152WC0802X Optometrist, Corneal and Contact Management (Licence: KS 2016) |
Enumeration Date | 2010-08-25 |
Last Update Date | 2019-05-29 |