| NPI | 1750542825 |
|---|---|
| Former Name | RENEE LYNN TJEERDSMA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AZ 2004) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MN 3142) |
| Enumeration Date | 2008-06-22 |
| Last Update Date | 2022-09-13 |