NPI | 1982748851 |
---|---|
Former Name | HOLLY MELINDA HOLT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: AR 2565) |
Additional Taxonomies | 152W00000X Optometrist (Licence: MO 2005020646) |
Enumeration Date | 2007-02-16 |
Last Update Date | 2007-07-08 |