| NPI | 1417144718 |
|---|---|
| Former Name | ERICA DAWN JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MI 4901004753) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CA 13410TPA) |
| 152WP0200X Optometrist, Pediatrics (Licence: MI 4901004753) | |
| 152WV0400X Optometrist, Vision Therapy (Licence: MI 4901004753) | |
| Enumeration Date | 2007-10-01 |
| Last Update Date | 2013-09-09 |