NPI | 1619126364 |
---|---|
Former Name | JULIE A MASTERS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 152W00000X Optometrist (Licence: MI 4901004512) |
Additional Taxonomies | 152W00000X Optometrist (Licence: IN 18003551) |
Enumeration Date | 2008-09-17 |
Last Update Date | 2020-01-13 |