| NPI | 1548436561 |
|---|---|
| Former Name | BREANNE MICHELLE PAUL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: KS 1178) |
| Additional Taxonomies | 152WL0500X Optometrist, Low Vision Rehabilitation (Licence: KS 1178) |
| Enumeration Date | 2008-04-30 |
| Last Update Date | 2017-04-13 |