Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | TUV009041 | NY |
NPI | 1003463654 |
---|---|
Provider Name | Julie Kaur Bhalla |
First Address | Winnipeg, MB R2C3Y4 |
Second Address | New York, NY 10028-1404 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/08/2019 |
Last Update Date | 19/08/2019 |