Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | ODP-100319 | ID |
N | 152WC0802X | Optomitrist - Corneal and Contact Lenses | 046010393 | IL |
NPI | 1013220979 |
---|---|
Provider Name | Dr. Ileen S Huh |
First Address | Lapwal, ID 83540-0367 |
Second Address | Lapwal, ID 83540-0367 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2010 |
Last Update Date | 24/10/2019 |