NPI | 1952663536 |
---|---|
Former Name | FAITH ANN MASCHMANN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: MO 2012017717) |
Additional Taxonomies | 152WP0200X Optometrist, Pediatrics (Licence: MO 2012017717) |
Enumeration Date | 2012-06-11 |
Last Update Date | 2013-11-05 |