| NPI | 1063568152 |
|---|---|
| Former Name | ELIZABETH LECLAIRE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OR AT3479) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MI 4901004355) |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2024-10-07 |