| NPI | 1891007688 |
|---|---|
| Former Name | MICHELLE LAUREN ZICKEL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: PA OEG002586) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: ME 1048) |
| 152W00000X Optometrist (Licence: IL 046010377) | |
| 152W00000X Optometrist (Licence: MA 4902) | |
| 152W00000X Optometrist (Licence: ME 1048) | |
| Enumeration Date | 2010-07-08 |
| Last Update Date | 2024-09-11 |