| NPI | 1932487493 |
|---|---|
| Former Name | DANAE ADRIANNE JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MI 4901004769) |
| Additional Taxonomies | 171000000X Military Health Care Provider (Licence: MI 4901004769) |
| Enumeration Date | 2011-08-01 |
| Last Update Date | 2024-10-09 |