| NPI | 1740578202 |
|---|---|
| Other Name | KRISTEN NICOLE GAUS MIKKELSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OR 3466ATI) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NV 703) |
| Enumeration Date | 2011-07-19 |
| Last Update Date | 2021-10-14 |