NPI | 1932586435 |
---|---|
Former Name | JENNIFER A. WALL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207W00000X Ophthalmology (Licence: TX T5690) |
Additional Taxonomies | 207W00000X Ophthalmology (Licence: FL 141348) |
Enumeration Date | 2015-05-04 |
Last Update Date | 2024-04-30 |