Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XL0004X | Low Vision | 579-26 | WI |
NPI | 1427406610 |
---|---|
Provider Name | Elizabeth Nowlin Eng |
First Address | Brookfield, WI 53045-1608 |
Second Address | Brookfield, WI 53045-1608 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/05/2016 |
Last Update Date | 27/05/2016 |