NPI | 1134829732 |
---|---|
Former Name | HANNAH TEAR GAUDETTE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: MI 4901005675) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2023-03-03 |
Last Update Date | 2024-01-04 |