| NPI | 1114215464 |
|---|---|
| Former Name | CHERYL BAKER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CO 2839) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MI 2051528) |
| Enumeration Date | 2011-07-20 |
| Last Update Date | 2020-08-10 |