| NPI | 1639509789 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THAO NGUYEN TRAN Physician 262-842-2358 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology |
| Additional Taxonomies | 152W00000X Optometrist |
| Enumeration Date | 2013-11-26 |
| Last Update Date | 2025-09-04 |