| NPI | 1043966955 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEVERLY ZWICKER Credentialing Manager 248-395-5166 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology |
| Additional Taxonomies | 152W00000X Optometrist |
| Enumeration Date | 2022-03-01 |
| Last Update Date | 2022-03-01 |