NPI | 1942867981 |
---|---|
Former Name | SYDNEY RAE COOPER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: MD TA2749) |
Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG003726) |
Enumeration Date | 2019-05-24 |
Last Update Date | 2024-10-14 |