NPI | 1841995594 |
---|---|
Former Name | CHRYSTAL L JOHNSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 156FX1800X Technician/Technologist, Optician (Licence: OH op.010042-sc) |
Additional Taxonomies | 156FX1800X Technician/Technologist, Optician (Licence: OH op.010042.sc) |
Enumeration Date | 2023-04-03 |
Last Update Date | 2023-04-03 |