NPI | 1952369308 |
---|---|
Other Name | KIRSTEN BLAKEMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: NC 1849) |
Additional Taxonomies | 152W00000X Optometrist (Licence: CO OPT.0003490) |
152W00000X Optometrist (Licence: MI 4901005392) | |
152W00000X Optometrist (Licence: WI 3572-35) | |
Enumeration Date | 2006-05-03 |
Last Update Date | 2024-04-29 |