| NPI | 1578517306 |
|---|---|
| Former Name | AMY JOANNE MITCHELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MO 200143624) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IL 046009247) |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2014-03-25 |