Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 0618002416 | VA |
NPI | 1003298829 |
---|---|
Provider Name | Dr. Laura Li |
First Address | Norfolk, VA 23510-2905 |
Second Address | Norfolk, VA 23510-2905 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2015 |
Last Update Date | 24/01/2018 |