| NPI | 1649700444 |
|---|---|
| Former Name | MOLLY K GORDER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MI 4901005143) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MO 2017019323) |
| Enumeration Date | 2017-06-14 |
| Last Update Date | 2021-02-09 |