| NPI | 1104171602 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BASEEM WAHAB Managing Optometrist 586-806-9333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MI 4901004569) |
| Enumeration Date | 2012-07-20 |
| Last Update Date | 2012-07-20 |