NPI | 1962014225 |
---|---|
Former Name | TRACY LUKASIEWICZ |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: AZ OPT-002510) |
Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG003716) |
Enumeration Date | 2020-08-18 |
Last Update Date | 2025-03-05 |