NPI | 1952672388 |
---|---|
Former Name | MELISSA ANN LIEPINS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: IL 046010451) |
Additional Taxonomies | 152W00000X Optometrist (Licence: MO 2011037693) |
Enumeration Date | 2012-01-17 |
Last Update Date | 2015-10-30 |