| NPI | 1376646372 |
|---|---|
| Former Name | MOLLY MARIE BRAUN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OR 1814T) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: WA OD00003969) |
| Enumeration Date | 2006-09-06 |
| Last Update Date | 2007-07-10 |