NPI | 1992954531 |
---|---|
Former Name | ANDREA DAWN BEEDLES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: KS 1802) |
Additional Taxonomies | 152W00000X Optometrist (Licence: MO 2008019684) |
Enumeration Date | 2008-09-18 |
Last Update Date | 2015-08-17 |